manual muscle testing Flashcards
what is a 5 rating on the Oxford Scale?
normal, moves through full range of motion against gravity with maximal resistance
what is a 4 rating on the Oxford Scale?
good, move through full ROM against gravity with moderate resistance
what is a 3 rating on the Oxford Scale?
fair, move through full ROM against gravity, unable to withstand any resistance (light)
what is a 2 rating on the Oxford Scale?
poor, full ROM gravity eliminated, unable to withstand any resistance
what is a 1 rating on the Oxford Scale?
trace, gravity eliminated plane, not motion, tension felt when muscle palpates
what is a 0 rating on the Oxford Scale?
gravity eliminated plane, no motion or tension
what are the first three steps in the process of manual muscle testing?
- introduce and reason for assessment
- ask about pain
- position client so movement will be against gravity
what occurs in the process of MMT after you have positioned them?
stabilise proximal to joint and ask client to move through full ROM
what occurs if the client is unable to move through full ROM in MMT?
move them into gravity-eliminated position
do you apply resistance in gravity-eliminated assessment?
no
what are the prime movers in shoulder flexion?
- anterior deltoid
- coracobrachialis
- pec major (clavicular head)
- biceps (both heads)
what is the start position and action for instructions in shoulder flexion?
start sitting arm by side, lift arm in front to shoulder height
where should you stabilise for shoulder flexion?
over clavicle and scapula
where should resistance be applied in shoulder flexion?
at distal end of humerus, push down
what are the start position and actions in shoulder flexion in a gravity-eliminated plane?
side lying with arm along side of body, support arm under elbow, move arm so hand is level with shoulder
what is the muscle that palpates in the gravity-eliminated position in shoulder flexion?
anterior deltoid
what are the prime movers in shoulder extension?
- latissimus dorsi
- teres major
- posterior deltoid
- triceps (long head)
what is the start position and action for instructions in shoulder extension?
sit with arm by side, move arm straight as far back as possible
where should you stabilise for shoulder extension?
over clavicle and scapula
where should resistance be applied in shoulder extension?
hand placed over distal end of humerus, push forward toward flexion
what are the start position and actions in shoulder extension in a gravity-eliminated plane?
side-lying arm along body, move arm backwards, support elbow
what is the muscle that palpates in the gravity-eliminated position in shoulder extension?
triceps palpated on posterior aspect
what are the prime movers in shoulder abduction?
- supraspinatus
- middle deltoid
what is the start position and action for instructions in shoulder abduction?
sit arm by side, raise arm to side to shoulder level
where should you stabilise for shoulder abduction?
over clavicle and scapula
where should resistance be applied in shoulder abduction?
hand placed over distal end of humerus push down toward body
what are the start position and actions in shoulder abduction in a gravity-eliminated plane?
supine (on back), arm by side, elbow supported, move arm from side
what is the muscle that palpates in the gravity-eliminated position in shoulder abduction?
middle deltoid below acromion and lateral to glenohumeral joint
what are the prime movers in wrist flexion?
flexor carpi radialis/ulanris, pollicus longus
how does the wrist flex against gravity?
bend forwards
where and how should you stabilise during wrist flexion?
stabilise on table with back of hand raised off table to allow slight extension
where is resistance applied in wrist flexion?
over heads of metacarpals on palm
what are the start position and actions in wrist flexion in a gravity-eliminated plane?
side of hand on table and bend wrist forward
what is the muscle that palpates in the gravity-eliminated position in wrist flexion?
palpate FCR on volar surface of wrist in line with 2nd metacarpal and radial to palmaris longus.
palpate FCU on volar surface proximal to pisiform bone
tendon may stick out
what are the prime movers in elbow flexion?
biceps, brachialis, brachioradialis
how does the elbow flex against gravity?
bends upwards at elbow toward shoulder
where and how should you stabilise during elbow flexion?
distal end of humerus or shoulder
where is resistance applied in elbow flexion?
hand placed on distal end of forearm, push down
what are the start position and actions in elbow flexion in a gravity-eliminated plane?
sit arm supported at 90 degrees of abduction (shoulder height), move hand toward shoulder
what is the muscle that palpates in the gravity-eliminated position in elbow flexion?
bicep palpated on anterior surface of humerus
what are the prime movers in elbow extension?
triceps
what is the start position and action of elbow extension against gravity?
lie on table, elbow in line with table edge, flexed forearm hangs then straighten arm
where and how should you stabilise during elbow extension?
support arm under anterior surface of distal humerus
where is resistance applied in elbow extension?
hand on dorsal surface of forearm, push toward flexion (down)
what are the start position and actions in elbow extension in a gravity-eliminated plane?
sit humerus supported in 90 degrees of abduction, elbow fully flexed straighten elbow
what is the muscle that palpates in the gravity-eliminated position in elbow extension?
triceps on posterior surface of humerus
what are the prime movers in finger PIP flexion?
flexor digitorum superficialis/profundus
what is the start position and action in finger PIP flexion against gravity?
back of hand on table, lift 4th finger, support by putting hand over fingers with 4th raised above, bend joint toward palm
how do you stabilise during finger PIP flexion?
all IP joints of other digits
where is resistance applied in finger PIP flexion?
using one finger apply to head of middle phalanx toward extension
what are the start position and actions in finger PIP flexion in a gravity-eliminated plane?
turn hand on side, hold all other fingers in extension, point to PIP joint and ask to try bend just this joint
what is the muscle that palpates in the gravity-eliminated position in finger PIP flexion?
palpate superficially on volar surface of proximal forearm toward ulnar side
what are the prime movers in thumb abduction?
adductor pollicus longus/brevis
what is the start position and action in thumb abduction against gravity?
forearm supinated (hand upwards) thumb abducted, bring thumb away from palm and try push back in
how do you stabilise in thumb abduction?
support wrist on ulnar side and hold in neutral position
where do you apply resistance in thumb abduction?
press with finger on first metacarpal toward adduction
what are the start position and actions in thumb abduction in a gravity-eliminated plane?
mid position (on side), neutral position thumb adducted, bring thumb away
what is the muscle that palpates in the gravity-eliminated position in thumb abduction?
palpate tendon of abductor pollicus longus at wrist joint distal to radial styloid and lateral to EPB
