Manual Muscle Testing

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Author:
kinnisonc
ID:
260224
Filename:
Manual Muscle Testing
Updated:
2014-02-10 19:11:17
Tags:
MMT PT Assessment II
Folders:
PT Assessment
Description:
Manual Muscle Testing Techniques
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  1. Shoulder Flexion
    • Muscle: Anterior Deltoid
    • Pt Position: Sitting
    • Stabilize: Superior Ipsilateral Shoulder
    • Palpation: Ant shoulder joint distal to lateral 1/3 clavicle
    • Resistance: Proximal to elbow toward extension 
    • Gravity Eliminated: Side Lying
  2. Shoulder Flexion & Adduction
    • Muscle: Coracobrachialis
    • Pt Position: Sitting
    • Stabilize: Superior ipsilateral shoulder
    • Palpation: Proximal 1/3 of anteromedial arm Resistance: Anteriomedial distal humerus toward extension
    • Gravity Eliminated: No other position
    • Modified Scale: 0, 1, 2, 3+, 4, 5
  3. Shoulder Extension
    • Muscle: Latissimus Dorsi, Teres Major, Posterior Deltoid
    • Pt Position: Prone
    • Stabilize: Thorax or scapula if weak
    • Palpation: Lateral to inferior angle of scapula
    • Resistance: Proximal to elbow on posteriomedial arm toward flexion
  4. Shoulder Abduction
    • Muscle: Middle Deltoid, Supraspinatus
    • Pt Position: Sitting
    • Stabilize: Superior Ipsilateral Shoulder Palpation: Inferior tip of acromion process Resistance: Proximal to elbow on lateral aspect of arm toward adduction
    • Gravity Eliminated: Supine
  5. Horizontal Abduction
    • Muscle: Posterior Deltoid
    • Pt Position: Prone
    • Stabilize: Ipsilateral Scapula  
    • Palpation: Inferior to lateral spine of scapula
    • Resistance: distal end of humerus toward adduction
    • Gravity Eliminated: sitting
  6. Horizontal Adduction
    • Muscle: Upper and Lower Pectoralis Major
    • Pt Position: Supine
    • Stabilization: Ipsilateral Shoulder/Upper Thorax
    • Palpation: anterior border of axilla (sternal head); inferior to middle of anterior border (clavicular head)
    • Resistance: Proximal to elbow in direction of abduction
    • Gravity Eliminated: Sitting (maybe supine)
  7. Shoulder External Rotation
    • Muscle: Infraspinatus, Teres Minor
    • Pt Position: Prone with towel
    • Stabilization: Ipsilateral thorax or scapula
    • Palpation: Inferior to spine of scapula (infraspinatus); Axillary border of scapula (teres major)
    • Resistance: proximal to wrist toward internal rotation
    • Gravity Eliminated: Prone, arm hanging off table
  8. Shoulder Internal Rotation
    • Muscle: Subscapularis, Pectoralis Major, Latissimus Dorsi, Teres Major
    • Pt Position: Prone with Towel
    • Stabilization: Ipsilateral thorax or scapula 
    • Palpation: deep in axilla along anterior surface of scapula
    • Resistance: proximal to wrist toward external rotation
    • Gravity Eliminated: Prone, arm hanging off table
  9. Scapular Elevation
    • Muscle: Upper Trapezius, Levator Scapulae
    • Pt Postion: Sitting
    • Stabilization: None, bilateral test
    • Palpation: lateral to cervical spinous processes
    • Resistance: superior shoulders towards depression
    • Gravity Eliminated: Prone
  10. Scapular Abduction & Upward Rotation
    • Muscle: Serratus Anterior
    • Pt Position: Supine (maybe sitting)
    • Stabilize: Ipsilateral Thorax
    • Palpation: Lateral upper 8-9 ribs, just anterior to lateral border of scapula
    • Resistance: grasp wrist and elbow, push downward toward scapular adduction
    • Gravity Eliminated: Sitting
  11. Scapular Adduction
    • Muscle: Middle Trapezius
    • Pt Position: Prone
    • Stabilize: Opposite Thorax
    • Palpation: between vertebral border of scapula and spinous processes of lower cervical and upper thoracic vertebrae
    • Resistance: Lateral scapula in direction of scapular abduction
    • Gravity Eliminated: No other position
    • Modified Scale: 0, 1, 2, 3+, 4, 5
  12. Scapular Adduction & Depression
    • Muscle: Lower trapezius
    • Pt Position: Prone
    • Stabilize: Posterior opposite thorax
    • Palpation: between root of scapular spine and spinous process of lower thoracic vertebrae
    • Resistance: lateral scapula in direction of scapular abduction and elevation
    • Gravity Eliminated: Prone
  13. Scapular Adduction & Depression
    • Muscle: Lower Trapezius
    • Pt Position: Prone
    • Stabilize: Posterior opposite thorax
    • Palpation: between root of scapular spine and spinous process of lower thoracic vertebrae
    • Resistance: Lateral scapula in direction of abduction and elevation
    • Gravity Eliminated: Prone
  14. Scapular Adduction & Downward Rotation
    • Muscle: Rhomboids (major/minor)
    • Pt Position: Prone
    • Stabilize: Contralateral thorax
    • Palpation: Between vertebral border of scapula and spinous process of C7-T5
    • Reistance: vertebral border of scapula toward scapular abduction
    • Gravity Eliminated: Sitting
  15. Elbow Flexion (biceps)
    • Muscle: biceps brachii (long/short)
    • Pt Position: seated, forearm supinated
    • Stabilization: Ipsilateral Humerus
    • Palpation: Bicipital tendon on anterior humerus
    • Resistance: Proximal to wrist toward elbow extension
    • Gravity Eliminated: Sitting, arm on table
  16. Elbow Flexion (brachilais)
    • Muscle: brachialis
    • Pt Position: Sitting, forearm supinated
    • Stabilize: ipsilateral Humerus
    • Palpation: Medial to distal attachment of biceps brachii
    • Resistance: proximal to wrist toward elbow extension
    • Gravity eliminated: Sitting, arm on table
  17. Elbow Flexion (Brachioradialis)
    • Muscle: Brachioradialis
    • Pt Position: Sitting, forearm neutral
    • Stabilize: ipsilateral humerus
    • Palpation: anterolateral forearm, just distal to lateral epicondyle of humerus
    • Resistance: proximal to wrist toward elbow extension
    • Gravity Eliminated: sitting, arm on table
  18. Elbow Extension
    • Muscle: Triceps brachii, Anconeus
    • Pt Position: Supine
    • Stabilize: Ipsilateral Shoulder
    • Palpation: proximal to olecranon
    • Resistance: Proximal to wrist toward elbow flexion
    • Gravity Eliminated: sitting, arm on table
  19. Supination
    • Muscle: Supinator, Biceps brachii
    • Pt Position: sitting, forearm supinated
    • Stabilize: inferolateral aspect of humerus
    • Palpation: posterior-superior radius, just distal to radial head (supinator); bicipital tendon on anterior humerus (biceps brachii)
    • Resistance: volar surface of ulna and dorsal surface of radius toward pronation (handshake grip)
    • Gravity Eliminated: Sitting
  20. Pronation
    • Muscle: Pronator Quadratus, Pronator Teres
    • Pt Position: Sitting, forearm supinated
    • Stabilize: inferolateral humerus
    • Palpation: Quadratus too deep to palpate; Teres, anterior surface of proximal 1/3 forearm
    • Resistance: volar surface of radius and dorsal surface of ulna toward supination
    • Gravity Eliminated: sitting
  21. Wrist Flexion
    (Ulnar Deviation)
    • Muscle: Flexor Carpi Ulnaaris
    • Pt Position: Sitting (forearm supinated)
    • Stabilize:Posterior distal forearm
    • Palpation: Anteromedial wrist proximal to pisiform
    • Resistance: Volar aspect of metacarpal bone V toward wrist extension & radial deviation
    • Gravity Eliminated: sitting, forearm neutral; pt flexes
  22. Wrist Flexion 
    (Radial Deviation)
    • Muscle: Flexor Carpi Radialis
    • Pt Position: Sitting (forearm supinated)
    • Stabilize: posterior distal forearm 
    • Palpate: Base 2nd Metacarpal lateral to midline of forearm
    • Resistance: volar aspect of metacarpals I & II toward wrist extension and ulnar deviation
    • Gravity Eliminated: Sitting, forearm neutral; pt flexes
  23. Wrist Extension
    (Ulnar Deviation)
    • Muscle: Extensor Carpi Ulnaris
    • Pt Position: sitting, forearm pronated
    • Stabilize: Volar distal forearm
    • Palpate: distal tendon, distal to ulnar styloid process
    • Resistance: dorsal metacarpals 1 & 2 twd flexion and radial deviation
    • Gravity Eliminated: Sitting, forearm neutral; pt extends
  24. Wrist Extension
    (Radial Deviation)
    • Muscle: Extensor carpi radialis brevis/longus
    • Pt Position: Sitting, forearm pronated
    • Stabilize: volar distal forearm
    • Palpation: distal tendon, distal to dorsal radial tubercle
    • Resistance: dorsal metacarpals 1 & 2, twd wrist flexion and ulnar deviation
    • Gravity Eliminated: Sitting, forearm neutral; pt extends

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