MMT Hand Placements and VC (Spine)

Question 1

Capital Extension (Grade 4-5)

Answer 1

“look at the wall, hold it, don’t let me push your head down”
One hand: beneath the overhanging head to support it should it give way with resistance
Resistance: over the occiput in a downward direction

Question 2

Capital Extension (Grade 0-2)

Answer 2

“tilt your chin up/ look back at me, don’t lift your head”
Both hands: support head under occiput with fingers just at the base of the occiput, lateral to the vertebral column
Palpate: capital extensors

Question 3

Cervical Extension (Grade 4-5)

Answer 3

“push up on my hand but keep looking at the floor, hold it, don’t let me push it down”
One hand: below chin ready to support the head should it suddenly give way during resistance
Resistance: over the parieto-occipital area in a downward direction

Question 4

Cervical Extension (Grade 0-2)

Answer 4

“try to push your head down into my hands”

Both hands: under patient’s head; fingers should be distal to occiput at the level of cervical vertebrae for palpation

Question 5

Capital Flexion (Grade 4-5)

Answer 5

“tuck your chin and keep your eyes straight ahead, don’t lift your head from table, hold it, don’t let me lift your chin”

Resistance: both hands cup under mandible to give resistance in an upward direction

Question 6

Capital Flexion (Grade 0-2)

Answer 6

“try to tuck your chin into your neck”

Palpate: cervical flexors

Question 7

Cervical Flexion (Grade 4-5)

Answer 7

“lift your head from the table while keep chin tucked while looking at the ceiling, do not lift shoulders, hold it, don’t let me push your head down”
Stabilization: on chest if trunk is weak
Resistance: two fingers on chin in a downward direction

Question 8

Cervical Flexion (Grade 0-2)

Answer 8

“roll your head to the left then to the right”

Both hands: palpate SCM on both sides

Question 9

Cervical Flexion to Isolate SCM (Grade 4-5)

Answer 9

“lift your head, keeping your head turn”

Resistance: on temporal area above the ear in a downward direction

Question 10

Cervical Flexion to Isolate SCM (Grade 0-2)

Answer 10

“Roll your head to the right then the left”

Palpate: SCM

Question 11

Cervical Rotation (Grade 4-5)

Answer 11

“turn your head and face the ceiling, hold it, don’t let me turn your head back”

Resistance: over the side of the patient’s head above the ear in a downward direction

Question 12

Cervical Rotation (Grade 0-2)

Answer 12

“turn your head as far as to the left as you can, keep chin level, repeat for right”

Palpate: SCM

Question 13

Trunk Extension (Lumbar spine) (Grade 4-5)

Answer 13

“raise your head, shoulders, and chest off the table. Come up as high as you can”

Stabilize: above the ankle or across pelvis if pt has weak hip extensors

Question 14

Trunk Extension (Thoracic Spine) (Grade 4-5)

Answer 14

“raise your head, shoulders, and chest to table level”

Stabilize: lower limbs at ankles

Question 15

Trunk Extension (Grades 0-2)

Answer 15

Palpate: lumbar and thoracic extensors muscles masses on both sides of spine

Question 16

Elevation of Pelvis (Grade 4-5)

Answer 16

“Hike your pelvis to bring it up to your ribs, hold it, don’t let me pull your leg down”

Both hands: with a lumbrical grip just above the ankle and pull caudally with smooth, even pull

Question 17

Elevation of Pelvis (Grade 2-3)

Answer 17

“bring your pelvis up to your ribs”
Grade 2: completes partial ROM
Grade 3: completes full ROM

Question 18

Trunk Flexion (Grades 3-5)

Answer 18

“keep your chin pointed toward the ceiling and lift your head, shoulders, and back of table”

Stabilize: pelvis if pt has weak hip flexors

Question 19

Trunk Flexion (Grades 0-2)

Answer 19

Palpate: at midline of thorax over linea alba

Question 20

Trunk Flexion Sequence 1

Answer 20

“lift head from table”

Question 21

Trunk Flexion Sequence 2

Answer 21

“lean forward”
One hand: cradles the upper trunk and head off table
Other hand: depression of rib cage (grade 2) or palpation of rectus abdominis (grade 1)

Question 22

Trunk Flexion Sequence 3

Answer 22

“cough”
One hand: cradles upper trunk and head off table
Other hand: cough/depression of rib cage (grade 2); palpation of abdominal muscles (Grade 1)

Question 23

Trunk Rotation (Grade 3-5)

Answer 23

“with your chin pointed toward the ceiling, lift your head and shoulders from the table, lift your head and shoulders from the table taking right elbow to your left knee then other way”

Palpate: obliques

Question 24

Trunk Rotation (Grade 2)

Answer 24

“keep your chin pointed to the ceiling while you lift your head, reach toward your right knee then left”
One hand: external oblique on one side then other
Other hand: placed on lateral part of abdominal wall distal to rib cage

Question 25

Trunk Rotation (Grade 0-1)

Answer 25

“try to lift up and turn to your right then your left”
One hand: support patient’s head
Other hand: palpate abdominal muscles