MMT Flashcards
MMT
manual muscle testing - method of assessing strength(not torque) that makes use of muscle or muscle groups ability to move against gravity or manual resistance - rating assigned after test - can utilize to initially test PROM and AROM
Break test
with resistance applied at end range - gradually increase resistance until movement caused by therapist
resistance through the range
sometimes called “make test”(not common) Disadvantages: - reliability is not good - therapist needs to be strong enough - takes a lot of time
MMT grading
5 = normal = 100% 4 = good = 80% 3 = fair = 50% 2 = poor = 20% 1 = trace = 5% 0 = zero = 0% - includes + and - system
factors to determine/rate a muscle grade
1) gravity 2) manual resistance 3) palpation(presence or absence of contraction)
MMT subjectivity
PT’s strength is variable - PT’s experience
screening tests
useful for more generalized involvement - screen upper and lower body in small amount of time - then narrow to specific joints - might be difficult to pick up impairments when using large muscle groups
considerations when performing MMT
1) limited ROM 2) Fatigue 3) Pain 4) Substitution
Limited ROM consideration
- specify rating for pt’s current ROM - ex: elbow flexion: 4 (0 - 90 degrees) - pt can only go from 0 to 90
Fatigue consideration
- allow pt to rest specific muscles - either move to other muscles and go back - wait until next treatment
pain consideration
- shouldn’t be performed if MMT increases pain(invalid) - many times, pt will have pain and okay to perform MMT
substitution consideration
- body avoids using muscles that are injured or weak by compensating - correct patient into proper motion and rate
MMT precautions and limitations associated with pt’s with neuromuscular conditions
- spasticity(increase in muscle tone) - don’t rate tone as strength - may be able to rate strength on some muscles
MMT precautions and limitations associated with pt’s with cardiovascular conditions
- no valsalva maneuver - monitor BP and changes
contraindications to performing MMT
acute inflammation or pain in the area - swelling or heat - will increase pain
1 RM
max amount of force in 1 repetition - may perform with free weights or cable tensiometers
advantages of 1 RM over MMT
- less subjectivity - functional test - valid
disadvantages of 1 RM to MMT
- trial and error(length of time) - fatigue from finding specific weight - difficult to isolate one muscle - lots of muscles at once
HHD
hand held dynamometer - microfet = most common
issues to be aware of with HHD’s
- only measures force - usually use a make test - isometric - hard to get an accurate reading with break - stabilization of unit, examiner, and patient - test in gravity-minimized position whenever possible(don’t want body part weight involved)
reliability with HHD
1) tester = tester strength is an issue 2) device = verify that device is accurate and calibrated 3) test procedures = same position and technique must be used 4) patient = must make sure it is the max value or close
advantages of HHD to MMT
- objective test - can take tester strength out of test(straps) - portable and inexpensive
disadvantages of HHD to MMT
- only isometric - can’t always take tester strength out
