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Adult Rehab > MMT > Flashcards

MMT Flashcards

1
Q

Method for measuring tension in a muscle/group of muscles

A

Manual muscle testing

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2
Q

MVC

A

Maximum voluntary contraction=”maximum tension production under voluntary effort” in MMT AKA greatest amount of tension a muscle can generate and hold only for a moment

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3
Q

Symptoms of muscle fatigue include:

A

cramping, burning, tremors due to accumulation of lactic acid

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4
Q

Name some primary conditions resulting in muscle strength limitations

A

Primary: Lower motor neuron disorders: peripheral neuropathies, peripheral nerve injuries…
Spinal cord injury
Guillain-Barré syndrome
Cranial nerve dysfunction
Muscle diseases: muscular dystrophy, myasthenia gravis…
Neurological conditions:
LMN with paralysis (Can help diagnose): PNI, SCI
UMN with selective control only!

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5
Q

Secondary conditions resulting in muscle strength limitations

A 
Burns
Amputations
Hand trauma
Arthritis
Fractures
Other orthopedic conditions 
Bedrest 
Disuse
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6
Q

MMT should be done with individuals who…

A

have selective, isolated movements…
“Inappropriate for patients who lack the ability to contract a single muscle or a muscle group in isolation, such as patients who exhibit patterned movement”

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7
Q

Manual Muscle Testing Precautions include:

A

Inflammation or pain in region
Dislocation or unhealed fracture
Recent surgery
Myositis ossificans
Bone carcinoma/fragile bone condition
When resistive movement is contraindicated:
Osteoporosis, subluxation, joint hypermobility, hemophilia or cardiovascular risk/disease, abdominal surgery/hernia, fatigue that exacerbates the patient’s condition…
Precautions include: back/neck surgery (always according to the physician)

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8
Q

MMT may begin with…

A

Gross Strength Screening:
Examination of medical record…
Observation of the client entering the clinic and moving about
Observation of the client performing functional activities…remove an article of clothing, shaking hands, etc.
Performance of a gross check of bilateral muscle groups (similar to AROM Scan)
Examination of medical record for results of previous muscle test and ROM assessment

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9
Q

T/F: cannot measure muscle endurance, motor control, or the client’s ability to use the muscles for functional activities

A

True

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10
Q

3 types of muscle testing

A
  1. Gross Strength Screen
    a.Screen strength of muscle groups (a motion
    -Indication: should i perform a manual muscle test?
  2. Manual Muscle Testing
    a.Test strength of each individual muscle
    -Indications: SCI/PNI
    b. Test strength of muscle groups with similar function
    -indications: general strength, orthopedic
    conditions, arthritis, etc.
  3. Functional
    a. Test strength to perform certain functions
    -Indications: resistance not allowed, assessed
    through activity
    -May be other reasons client cannot perform:
    depression, motivation, environment, pain
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11
Q

When would you test strength of muscle groups vs. individual muscles?

A

Muscle groups: Enough strength to perform various motions… I.e., elbow flex/ext.
-general strength, orthopedic conditions, arthritis
Individual (Specific): elbow example… different positioning and palpation for biceps, brachialis, brachioradialis. Helps differentiate level of injury (I.e., brachial plexus injury/SCI) related to nerve or nerve root involvement and whether the involvement is partial or complete.

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12
Q

Normal muscle strength depends on:

A

Age, gender, lifestyle, muscle size and type and speed of contraction, effect of previous training, joint position during muscle contraction, time of day, temperature, and fatigue
-Be knowledgeable about how patient’s diagnosis may affect muscle strength

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13
Q

Most important to the reliability of the scores of MMT repeated tests is…

A

Strict adherence to the exact procedures of testing.

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14
Q

Screening for MMT includes…

A

Review chart for MMT results
Observe movement–entering clinic, etc
Observe functional activities with UE
Perform a gross check of bilateral muscle groups…
-seated, against gravity, and resistance

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15
Q

T/F: For MMT, position patient to move with gravity

A

F. Position patient to move against gravity. Test all muscles in one position before changing position

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16
Q

Steps to MMT

A
  1. Determine PROM (available range)
  2. Assess Proximal to Distal
  3. Position patient to move against gravity
  4. Stabilize proximal attachment
  5. Ask patient to move and observe
  6. If able to move through full available range against gravity: apply resistance on the distal end of moving part at the end of the available range
    a. Takes no resistance=Fair (3)–Full ROM but breaks
    with any resistance
    b. Takes minimal resistance=Fair+ (3+)
    c. Takes moderate resistance=Good (4)–gives at end of
    range a bit
    d. Takes maximum (normal) resistance=normal (5)
  7. If unable to move through available range: position with gravity eliminated (decreased)
  8. If able to move through full available range in gravity-eliminated: apply resistance at distal end of moving part
    a. Takes minimal resistance=Poor+ (2+)
    b. Takes no resistance=Poor (2)
  9. If no motion: palpate prime mover
    a. Tension=Trace grade (1)–see tendon tense but no
    movement
    b. No tension=Zero grade (0)
17
Q

Scoring for MMT

A

Zero grade (0): no tension
Trace grade (1): Tension. Muscle pops up or tenses
Poor (2): takes no resistance in gravity eliminated
Poor+ (2+): takes minimal resistance in gravity eliminated
Fair (3): Can complete full ROM against gravity, but takes no resistance
Fair+ (3+): Takes minimal resistance
Grade 4 (Good): able to complete full range of motion against gravity and can tolerate strong resistance without breaking the test position…”gives” or “yields” to some extent at the end of its range with maximum resistance.
Grade 5 (Normal): can maintain end-point against maximum resistance.

18
Q

What does Zero grade (0) in MMT signify?

A

No tension

19
Q

What does Trace grade (1) in MMT mean?

A

The muscle pops or tenses, but no movement occurs

20
Q

What does a 2 in MMT signify?

A

Takes no resistance in gravity eliminated

21
Q

This number in MMT signifies that the client can take minimal resistance in a gravity eliminated position

A

Poor+ (2+)

22
Q

This number in MMT signifies that the client Can complete full ROM against gravity, but takes no resistance against gravity

A

Fair (3)

23
Q

What does a Fair+ (3+) in MMT signify?

A

Takes minimal resistance against gravity

24
Q

What does a Grade 4 in MMT mean?

A

(Good). Able to complete full range of motion against gravity and can tolerate strong resistance without breaking the test position…“gives” or “yields” to some extent at the end of its range with max resistance

25
Q

What number is assigned with normal performing in MMT?

A

Grade 5. Can maintain end-position against max resistance

26
Q

T/F: When reporting muscle strength (MMT) it is best to describe muscle strength in a way that links it to occupation

A

True. Duh! For example: Due to weakness of wrist extensors and finger flexors, client is unable to maintain grasp on small objects.

27
Q

“Slight” in muscle grade means

A

Muscle grade is in G (good)/4 range. Able to complete full range of motion against gravity and can tolerate strong resistance without breaking the test position…“gives” or “yields” to some extent at the end of its range with max resistance

28
Q

“moderate” muscle grade

A

Muscle grade is in the F to F+ range/3 to 3+. Client can either complete full ROM against resistance but can’t take any resistance (3) or can take minimal resistance (3+)

29
Q

“Severe” muscle grade

A

Muscle grade is below F (below 3). Put in gravity eliminated position

30
Q

Passive range Vs. Active range Vs. Manual muscle test

A

Passive range: determines “available range”
Active range is usually a reflection of muscle strength
Manual muscle tests indicates muscle strength

31
Q

If a client’s PROM (available range) is 0-90 degrees and the client moves through full available range and takes minimal resistance, what does he score in MMT?

A

F+/3+

32
Q

If there is a problem with muscle strength, you should ask yourself…

A

Is the nature of the disability/injury on that the client is expected to gain muscle strength or will muscle strength deteriorate?

33
Q

If muscle strength is low but is expected to improve, consider…

A

If muscle strength is expected to improve:
-Are there muscle imbalances (can lead to deformity)
-Is there weakness at an area limiting function?
-Should these muscles be protected from overuse and
fatigue?
-Consider time frame of recovery
-is there generalized weakness or are specific
muscles/muscle groups affected?
-Is the weakness preventing client from possibly using
adaptive equipment?

34
Q

If muscle strength is low and is expected to deteriorate, consider…

A

How quickly will the muscle deteriorate (time frame)
Will there be periods of remission?
Will HEP/strengthening accelerate expected muscle loss?
Will muscle loss happen proximal to distal?
Is adaptive equipment an option?
Is loss of strength expected to be accompanied with loss of ROM?
Will muscle loss be generalized or expected to occur in specific muscles only?

35
Q

If client cannot go through full available range of motion actively when assessing pt, what should you do next?

A

put pt in gravity eliminated position

Adult Rehab (7 decks)

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