MMT/Functional Strength

Question 1

How we define strength…?

Answer 1

the ability of a muscle to develop tension or torque

forced generated over a single episode against an immovable resistance

muscle must produce force in a static position

Question 2

Strength is…

Answer 2

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

Isotonic - concentric/eccentric
Isokinetic - strength through a range
Isometric - forced generation w/o movement

Question 3

How do we access?

Answer 3

Manual
MMT
Dynamomtery

Electronically
Cybex
Kincom
Biodex

Functional Assessments

Question 4

Functional Assessments

Answer 4

Balance
Excursion
Lunge
Step-up/Step-down
Jump and hop tests
30 sec chair stands
6 min walk test
Single limb balance
Step-ups Squats (double/single limb)

Question 5

Manual Muscle Screening

Answer 5

Group is placed in a position of convenience
Provides a quick overview of gross strength
Testing groups rather than specific muscles
Not quantifiable
Determines weak or strong, pailful or painless

Question 6

Manual Muscle Testing

Answer 6

Done to determine the capability of muscles or muscle groups to function in movement and their ability to provide stability and support.

Measure muscle strength (weakness) of a particular muscle
Ability of a muscle to develop tension against resistance in a particular position

Question 7

Why perform MMT?

Answer 7

Objective measurement
Provides ability for retesting to determine if a change is begin made
Provides a manner of communication with other health care providers
Relate results to activity or participation domains

Question 8

Testing sequence

Answer 8

Explain the purpose of the MMT
Place the patient in the gravity-resisted position
Stabilize proximal joint segment while demonstrating the motion via PROM
Return segment to starting position
Ask the patient to actively perform the motion while palpating the muscle being tested, AROM
Correct test position (if needed)
Apply resistance (if full ROM against gravity) with verbal cueing
Select appropriate grade

Question 9

Resistance

Answer 9

Applied only if patient can perform full AROM against gravity
Applied perpendicular to the distal end of the distal segment of the joint being tested
“Break Test” - apply resistance against patient, gradually increasing 5 secs until breaks muscle contraction

Question 10

Grades

Answer 10

5, full ROM against gravity, max resistance
4, full ROM against gravity, mod resistance
3+, full ROM against gravity, min resistance
3, full ROM against gravity
3-, >50% ROM against gravity, full ROM in gravity-eliminated position
2+,

Question 11

Considerations

Answer 11

Test uninvolved side first
Allows patient to understand test
Provides clinician comparison
Patient modesty, draping

Question 12

Body mechanics

Answer 12

Use proper body mechanics

Move patient closer to you

Question 13

Determining a grade…

Answer 13

“FULL” ROM is determined by what the patient’s ROM is, even if it is not considered “normal”