ANKLE AND FOOT MMT Flashcards
Ankle plantar flexion MMT:
Muscles:
Inn:
Client position/ stabilization:
Gravity reduced:
Palpation:
Grade:
Muscles: gastroc and soleus
Inn: S1-S2
Client position/ stabilization: standing (2-5)
Gravity reduced: supine (0-2+)
Palpation: achilles tendon or muscle belly
Grade: 5- 25+ full heel raises
4: 10-24 heel raises
3: 1-9 heels raises
2+: completed full range and tolerates maximal resistance (prone)
2: partial range of 1 rep in standing or completed full range in NWb without resistance (prone)
2-: partial range (prone)
NOTE: To isolate the soleus…perform all of the tests described above with the knee flexed. For grades 0-2+, the knee is flexed to 90º in prone.
Dorsiflexion and inversion MMT:
Muscles:
Inn:
Client position/ stabilization:
Gravity reduced:
Palpation:
Muscles: tibialis anterior
Inn: L4-S1
Client position/ stabilization: sitting (3-5)
Gravity reduced: long sit (2-0)
Palpation: middle leg lateral to midline
NOTE: - The patient is asked to hold their foot in an “up and in” direction. - - Toes must remain relaxed. - Resist over the medial/dorsum side of the foot.
inversion MMT
Muscles:
Inn:
Client position/ stabilization:
Gravity reduced:
Palpation:
Resist:
Muscles: tibialis posterior
Inn: L5-S1
Client position/ stabilization: sidelying on the test side (3-5)
Gravity reduced: long sit (2-0)
Palpation: between medial malleolus and navicular
Resist: medial/dorsum side of the foot
NOTE: The patient is asked to hold their foot in an “inward” direction. Make sure to monitor for substitution of tibialis anterior instead of tibialis posterior (keep foot more PF and not DF). Toes must remain relaxed.
eversion with plantar flexion MMT:
Muscles:
Inn:
Client position/ stabilization:
Gravity reduced:
Palpation:
Resist:
Muscles: fibularis longus and brevis
Inn: L4-S1
Client position/ stabilization: sidelying with the test side uppermost (3-5)
Gravity reduced: long sit (2-0)
Palpation: over mid to proximal lateral fibular
Resist: lateral/plantar side of foot
NOTE:
The patient is asked to hold their foot in a “outward” direction.
Toes must remain relaxed.
Great toe abduction:
Muscles:
Client position/ stabilization:
Palpation:
Muscles: abductor hallucus
Client position/ stabilization: preposition patient into great toe abduction
Palpation: medial great toe at proximal phalange
Hallux and toe MTP flexion MMT:
Muscles:
Inn:
Client position/ stabilization:
Palpation:
Resist:
Grade:
Muscles: lumbricals (toes 2-5) and FHB (great toes)
Inn: L5-S3
Client position/ stabilization: long sitting with foot off the edge of the table , all toes , stabilize metatarsals A&P
Palpation: lumbricals : between metatarsals
it is difficult to palpate FHB
Resist: Great toe- proximal phalanx
toes 2-5: resist all toes at the same time and resist at proximal phalanges
grade: Grade 3: AROM through full range without resistance Grade 2: AROM through partial ROM without resistance Grade 1: No motion, but palpable contraction is present
Grade 0: No motion or contraction is present
Hallux and toe DIP and PIP flexion MMT:
Muscles:
Inn:
Client position/ stabilization:
Palpation:
Resist:
Grade:
Muscles: FDL, FDB and FHL
Inn: L5-S2
Client position/ stabilization: long sitting (foot off the edge of the tableP , toes 2-5: stabilize metatarsals A&P, hallux : stabilize lateral sides of proximal phalanx
Palpation: FDL - posterior lower leg , medial to achilles
Resist: GT- resist at distal phalanx while stabilizing lateral sides pf proximal phalanx
toes 2-5: resist all toes at same time , resist on the distal phalanges
Grade: Grade 3: AROM through full range without resistance Grade 2: AROM through partial ROM without resistance Grade 1: No motion, but palpable contraction is present
Grade 0: No motion or contraction is present
Hallux and Toe MTP extension and IP extension of toes 2-5 MMT:
Muscles:
Inn:
Client position/ stabilization:
Palpation:
Resist:
Grade:
Muscles: EDL. EDB and EHB
Inn: L4-S1
Client position/ stabilization: Long Sitting (foot off edge of table), stabilize metatarsals laterally with palm cupping under foot for all toes
Palpation: EDL: anterior/middle lower leg between tib/fib
EDB/EHB: lateral dorsum of foot
Resist: Big toe: resist at proximal phalanx. Toes 2-5: Resist all toes at the same time. Resist on the proximal phalanges.
Grade: Grade 3: AROM through full range without resistance Grade 2: AROM through partial ROM without resistance Grade 1: No motion, but palpable contraction is present
Grade 0: No motion or contraction is present
Hallux IP extension MMT:
Muscles:
Inn:
Client position/ stabilization:
Palpation:
Resist:
Grade:
Muscles: EHL
Inn: L4-S1
Client position/ stabilization: Long Sitting (foot off edge of table), stabilize lateral sides of proximal phalanx of great toe
Palpation: EHL: stabilize proximal phalanx of great toe, palpate tendon as it runs over the dorsal side of the proximal segment
Resist: at distal segment of the great toe
Grade: Grade 3: AROM through full range without resistance Grade 2: AROM through partial ROM without resistance Grade 1: No motion, but palpable contraction is present
Grade 0: No motion or contraction is present
