Intro to Muscle Performance (9/4c)

Question 1

Muscle strength

Answer 1

“the maximal force a muscle or muscle group can generate at a specified or determined velocity”

Question 2

How we can test muscle activity

Answer 2

Electromyography (EMG)

Question 3

Strength testing

Answer 3

Used in all parts of Patient Management Model***

Examining their movement, determining diagnosis, in interventions, determining prognosis, and proving outcomes

Question 4

Isotonic contraction (strength testing)

Answer 4

force generated by a muscle while contracting, comprised of concentric and eccentric movements

1 Rep Max = Determine how much weight they can do full ROM for one rep
EX: quads - knee extension machine

Question 5

Isokinetic contraction (strength testing)

Answer 5

dynamic contraction but movement speed is controlled by machine

Dynamometer
EX: quads - test at 60 deg/sec, 90 deg/sec, etc

Question 6

Isometric contraction (strength testing)

Answer 6

muscle contraction without the muscle or joints moving; static tension

EX: Manual Muscle Testing, dynamometer, HHD

Question 7

Manual Muscle Testing (MMT)

Answer 7

A system of measurement using manually applied resistance to determine the strength of a muscle

Gravity based system, quantifies muscle strength, reliability adequate

Question 8

Ordinal Measurement Scale for MMT

Answer 8

6 point scale

0 = no muscle contraction
5 = movement through complete ROM against gravity and maximal resistance

Numbers mean the exact same thing as words

Question 9

Grades for MMT - Good/Normal

Answer 9

Normal (N or 5): Able to move through the FULL available range of motion, against gravity, and able to hold against MAX manual resistance

Good (G or 4): Able to move through FULL available range of motion, against gravity and able to hold against MODERATE manual resistance

Question 10

Grades for MMT - Fairs (+/-)

Answer 10

Fair + (F+ or 3+): Able to move through FULL available range of motion against gravity and able to hold against MINIMAL manual resistance

Fair (F or 3): Able to move through the FULL available range of motion, against gravity with NO manual resistance (FAIR TEST)

Fair – (F- or 3-): Able to move through OVER HALF the available range of motion against gravity and NO manual resistance

Question 11

Grades for MMT - Poors (+/-)

Answer 11

Poor + (P+ or 2+): Able to move through UNDER HALF the available range of motion against gravity and NO manual resistance

Poor (P or 2): Able to move through the FULL available range of motion in a GRAVITY MINIMIZED position

Poor – (P- or 2-): Able to move through PARTIAL range of motion in a GRAVITY MINIMIZED position and NO manual resistance

Question 12

Grades for MMT - Trace/Zero

Answer 12

Trace (T or 1): NO joint motion, GRAVITY MINIMIZED position, muscle contraction IS palpable or observable

Zero (0): NO observable or palpable muscle contraction

Question 13

Subjective part of MMT

Answer 13

amount of resistance pt tolerates during test

Validity above 3/Fair is much less than below 3

Question 14

Objective part of MMT

Answer 14

ability of pt to complete full ROM or hold position once placed there

ability to move part against gravity or inability to move at all

Question 15

Steps of MMT

Answer 15

1) explain purpose to pt
2) position patient and expose part
3) begin with fair test
4) compare to uninvolved side
5) test muscles using manual resistance if above fair/3 (via break test, make test, or resistance through ROM)

Question 16

Break test (MMT)

Answer 16

“Hold this position, don’t let me move you”

PT applies resistance until muscle contraction overcome by PT

Most commonly used in MMT

More force produced than the “make” test

Question 17

Make test (MMT)

Answer 17

“Push into me, start slowly and gradually increase”

Set force level (usually @ fixed position), ask patient to match it

Used for MVIC testing

Force lower than break test

Commonly used with HHD (not typically used with MMT)

Question 18

Resistance through ROM (MMT)

Answer 18

have patient do full ROM, PT push against

Question 19

Things to consider when assessing “normal” (MMT)

Answer 19

Size, age, gender

Symmetry, experience

Substitution, pain, motivation, ability, decreased ROM

Question 20

Body parts with special grades (MMT)

Answer 20

Finger/toes
Facial muscles
Trunk
Weight-bearing muscles

Question 21

MMT validity

Answer 21

Grades above Good (4) - not strong relationships with other strength measures

Grades below Good (4) - strong relationships with other strength measures

Question 22

MMT reliability

Answer 22

Variable depending on: muscle tested; experience/education of tester; patient’s motivation/understanding/fatigue

Need to use standardized methods

Question 23

Pros/Cons of MMT

Answer 23

PROS: Always available, Inexpensive, Useful for individual muscles

CONS: Imprecise, Reliability/validity issues; ceiling effects