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PT EXAM > Manual Muscle Testing > Flashcards

Manual Muscle Testing Flashcards

1
Q

Measurable force exerted by a muscle or group of muscles to overcome resistance in one maximal effort

A

Strength

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2
Q

Ability to contract a muscle repeatedly over a period of time

A

Endurance

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3
Q

Work produced per unit of time (product of speed and strength)

A

Power

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4
Q

Three primary approaches used to determine muscle strength

A

Isotonic
Isokinetic
Isometric

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5
Q

Testing of strength using constant external resistance

A

Isotonic

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6
Q

Since constant (isotonic) muscle tension rarely occurs, contraction is usually referred to as

A

Concentric or eccentric

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7
Q

Assess the con and ecc strength of muscle using ____________

A

Free weights, resistance machines

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8
Q

T/F gross strength of muscle groups is assessed rather than the strength of the individual muscles

A

T

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9
Q

An isolines if dyanamometer allows measurement of strength by having subject provide resistance through the ROM at a _________

A

Constant velocity

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10
Q

The isokinetic dynamometer provided _______ values at specific points in the ROM or throughout full ROM

A

Peak torque

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11
Q

Disadvantages to isokinetic

A

Cost of equipment is high

Considered non-functional since a muscle strength is assessed in non-weight bearing

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12
Q

During an isometric contraction, the muscle length remains _______ throughout the contraction

A

Almost the same

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13
Q

How is isometric muscle strength tested

A

Having the muscle generate force against an immovable resistance

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14
Q

What issues are eliminated in isometric contraction

A

Since muscle length is unchanged, issues with variability in muscle length and velocity of joint motion are eliminated

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15
Q

Most common methods of isometric testing

A

MMT and HHD

Manual muscle testing and Handheld dynamometry

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16
Q

What type of contraction is MMT

A

Isometric

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17
Q

Disadvantage of isometric contraction

A

Provides muscle strength data at only one point in ROM

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18
Q

Patients with significant muscle weakness are best assessed using

A

Manual muscle testing

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19
Q

T/F HHD and other instrumented forms of muscle testing are sensitive enough to detect low levels of strength

A

F

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20
Q

Patient’s with strength in the range of Good (4) to Normal (5) should be tested

A
  • Using HHD
  • strength testing (10 rep max)
  • isokinetic dynamometry
  • not MMT
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21
Q

Method of choice for the assessment of muscle strength of patient whose muscle test grades fall below Fair+ (3+)

A

MMT

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22
Q

What is manual muscle testing designed to measure?

A

Muscle strength which is defined as ability of muscle to develop isometric tension against resistance.

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23
Q

Some neuromusculoskeletal diseases that MMT is used to assess muscle strength

A
  • spinal cord injuries
  • Gillian-barre syndrome
  • muscular dystrophy
  • multiple sclerosis
  • RA & OA
24
Q

Manual muscle testing assists the PT in (4)

A

1- diagnosis and prognosis by determining level of lesion
2- planning treatment program
3- evaluating progress or regression of patient
4-basic starting point for developing an exercise program for the patient

25
Q

T/F we can eliminate gravity when performing a MMT

A

F we can lessen gravity, but cannot eliminate

26
Q

Why is palpating of muscle being tested important?

A

There can be an active contraction even if limb movement is not observed

27
Q

Where does the examiner apply resistance force

A

Perpendicular to the distal end of the distal segment of the bone being tested

28
Q

Difference between make vs. break test

A

MAKE - patient exerts a max force against the resistance applied on the limb by the examiner throughout the ROM - patient is instructed to pull or push as hard as they can
BREAK - patient holds the position of the limb and the examiner applies max resistance until the patient’s maximal muscular effort is overcome and the limb begins to move. - patient is instructed, do not let me move your arm

29
Q

Required to ensure desired action occurs at the specific muscle we are testing

A

Stabilization (Fixation)

30
Q

Occurs when muscle or muscle groups attempt to compensate for the lack of function of a weak or paralyzed muscle

A

Substitution

31
Q

Classic example of substitution

A

Hip hike using QL to substitute for a weak gluteus medius

*Substitution can never be allowed

32
Q

Development of tension by the muscle varies based on both,

A

Muscle physiology issues

Patient issues

33
Q

Muscle physiology issues (4)

A

1 - number and firing rate of motor units activated
2 - length of muscle at time of contraction
3 - cross-sectional area of muscle
4 - fiber type composition of muscle

34
Q

Patient issues (5)

A 
1- variation in true effort
2- willingness to suffer pain or discomfort
3- cognition and language
4- fatigue and age
5- psychological issues
35
Q

What can a PT control during MMT (4)

A

1- correct patient positioning
2- proper point of application of resistance
3- use of proper stabilization techniques
4- motivation of patient

36
Q

PT can demonstrate by passively moving distal segment through ROM, if

A

Patient does not understand

Patient is extremely weak

37
Q

From starting position, ask patient to perform required movement, then

A

Palpate muscle and maintain stabilization

Observe for substitutions

38
Q

If patient can complete full ROM against gravity,

A

PT applies resistance with palpation hand at END of the ROM in the exact opposite direction of the movement

39
Q

If patient can complete full ROM against gravity, apply resistance for ______ seconds instructing the patient to ________.
Continue to apply resistance until _____ or until resistance was held for _______.

A

4-5
Continually hold
Patient breaks
4-5 sec

40
Q

If patient cannot complete full ROM against gravity,

A

Reposition the patient in gravity lessened position and repeat the procedure we previously used WITHOUT applying resistance

41
Q

Higher levels of inter-rated reliability are attained when

A

The uniform method of MMT is used by all testers

42
Q

MMT is more valid for grades of

A

3 or lower

43
Q

Importance of the order of muscle testing when performing a MMT

A
  • to prevent fatigue of proximal muscles, order of the muscles we are testing from proximal to distal
  • MMT progression should be planned to prevent frequent change of patient position
44
Q

The PT should be very cautious when using MMT:

A
  • to assess muscle strength in the presence of spasticity or increased muscle tone as a result of a neurological impairment
  • when significant pain or muscle guarding is present
45
Q

Against gravity grades

A

3,3+,4,5

46
Q

Movement though the full ROM against gravity

A

3, F, Fair

47
Q

Movement through the full ROM against gravity and able to hold against minimum resistance

A

3+,F+, Fair plus

48
Q

Movement through the full ROM against gravity and able to hold against moderate resistance

A

4,G, Good

49
Q

Movement through the full ROM against gravity and able to hold against maximum resistance

A

5,N,Normal

50
Q

Gravity lessened grades

A

0,1,2-,2,2+,3-

51
Q

No evidence of contraction by vision or palpation

A

0,0,zero

52
Q

Slight contraction, but NO MOVEMENT

A

1,Tr, Trace

53
Q

Movement through partial ROM in gravity-lessened position

A

2-,P-, poor minus

54
Q

Movement through full ROM in gravity-lessened position

A

2,P,Poor

55
Q

Movement through full ROM in gravity-lessened position and up to 1/2 ROM against gravity

A

2+,P+, poor plus

56
Q

Movement through full ROM in gravity-lessened position and more than 1/2 ROM against gravity

A

3-,F-, Fair minus

57
Q

Muscle performance includes what 3 things

A

Strength
Endurance
Power

PT EXAM (6 decks)

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