MMT Hand Placements and VC (UE)

Question 1

Scapular Abduction and Upward Rotation (Grade 4-5)

Answer 1

“hold your arm here, don’t let me move it”
Stabilization: stabilize trunk below scapula on same side
Resistance: just above elbow in a backward direction

Question 2

Scapular Abduction and Upward Rotation (Grade 2)

Answer 2

“hold your am, relax, now hold your arm up”
Stabilization: cupping inferior angle
Other hand: support at elbow

Question 3

Scapular Abduction and Upward Rotation (Grade 0-1)

Answer 3

“try to hold your arm in this position”
One hand: support at elbow
Other hand: palpate serratus anterior along axillary border of scapula

Question 4

Scapular Elevation (Grade 4-5)

Answer 4

“shrug your shoulders, hold it, don’t let me push them down”

Resistance: both hands over top of shoulders in downward direction

Question 5

Scapular Elevation (Grades 0-2)

Answer 5

“Raise your shoulder toward your ear (shrug)”
One hand: support test shoulder in palm of hand
Other hand: palpate upper trap above the clavicle

Question 6

Scapular Adduction (Retraction) (Grade 4-5)

Answer 6

“lift elbow toward ceiling, hold it, don’t let me push it down”
Stabilization: the contralateral scapular area to prevent trunk rotation
Resistance: at distal humerus in a downward direction

Question 7

Scapular Adduction (Retraction) (Grade 0-2)

Answer 7

“try to lift your elbow toward the ceiling”
One hand: cradle patient’s shoulder and arm
Other hand: palpate middle trapezius fiber

Question 8

Scapular Depression and Adduction (Grade 5)

Answer 8

“hold your arm, don’t let me push it down”
Resistance: over distal forearm just above wrist in a straight downward direction
Stabilization: at inferior angle of scapula (palpate middle trap fibers)

Question 9

Scapular Depression and Adduction (Grade 4)

Answer 9

“hold your arm, don’t let me push it down”
Resistance: over distal humerus just above elbow in a straight downward direction
Stabilization: at inferior angle of scapula (palpate middle trap fibers)

Question 10

Scapula Depression and Adduction (Grades 0-2)

Answer 10

“try to lift your arm from the table past your ear”
One hand: support patient’s arm under the elbow
Other hand: palpate middle/lower trap

Question 11

Scapular Adduction (Retraction) and Downward Rotation (Grade 4-5)

Answer 11

“lift your hand, hold it, don’t let me push it down”
Resistance: on humerus just above elbow in an outward/downward direction
Other hand: palpate rhomboids

Question 12

Scapular Adduction (Retraction) and Downward Rotation (Grade 0-2)

Answer 12

“try to move your hand away from your back”
One hand: support arm by grasping wrist
Other hand: palpate rhomboids under the vertebral border of scapula

Question 13

Latissimus Dorsi (Grades 4-5)

Answer 13

“hold your arm, don’t let me move it”
Resistance hand: over medial forearm above patient’s wrist in an outwards/downward direction
Other hand: palpate latissimus dorsi

Question 14

Latissimus Dorsi (Grades 0-2)

Answer 14

“try to lift your arm up”

One hand: palpate latissmus dorsi

Question 15

Shoulder Flexion (Grade 4-5)

Answer 15

“raise arm to 90*, hold it, don’t let me push it down”
Stabilization: the shoulder
Resistance: over distal humerus just above the elbow in a downward direction

Question 16

Shoulder Flexion (Grade 0-2)

Answer 16

“try to raise your arm”
One hand: cradle test arm at elbow
Other hand: palpate anterior deltoid

Question 17

Shoulder Extension (Grade 4-5)

Answer 17

“lift your arm as high as you can, hold it, don’t let me push it down”

Resistance hand: over posterior arm just above the elbow in a downward direction

Question 18

Shoulder Extension (Grade 0-1)

Answer 18

“try to lift your arm as high as you can”

One hand: palpate posterior deltoid/teres minor

Question 19

Shoulder Extension (Grade 2-3)

Answer 19

Grade 2- partial ROM with no resistance

Grade 3- full ROM with no resistance

Question 20

Shoulder Abduction (Grade 4-5)

Answer 20

“lift your arm out to the side to shoulder level, hold it, don’t let me push it down”
Resistance: contoured over arm just above the elbow in a downward direction
Stabilization: over shoulder

Question 21

Shoulder Abduction (Grade 2)

Answer 21

“take your arm out to the side”

One hand: palpate middle deltoid

Question 22

Shoulder Abduction (Grade 0-1)

Answer 22

“take your arm out to the side”
One hand: palpate middle deltoid
Other hand: on forearm

Question 23

Shoulder Horizontal Abduction (Grade 4-5)

Answer 23

“lift your arm up toward the ceiling, hold it, don’t let me push it down”
Resistance hand: over posterior arm just above elbow in downward direction
Other hand: palpate posterior deltoid

Question 24

Shoulder Horizontal Abduction (Grade 0-2)

Answer 24

“try to move your arm backward”
One hand: support forearm under volar aspect
Other hand: palpate posterior deltoid

Question 25

Shoulder Horizontal Adduction (Both heads) (Grade 4-5)

Answer 25

"move your arm across your chest, hold it, don't let me pull it back" One hand: palpate pectoralis major Other hand: just proximal to the elbow or wrist in opposite direction

Question 26

Shoulder Horizontal Adduction (Clavicular) (Grade 4-5)

Answer 26

"move your arm up and in" One hand: palpate clavicular pectoralis major Other hand: just proximal to elbow or wrist in a up and inward motion

Question 27

Shoulder Horizontal Adduction (Sternal) (Grade 4-5)

Answer 27

"move your arm down and in" One hand: palpate sternal pectoralis major Other hand: just proximal to elbow or wrist in an up and outward motion

Question 28

Shoulder Horizontal Adduction (Grade 0-2)

Answer 28

"try to move your arm across your chest" One hand: support length of forearm and hold limb at wrist Other hand: palpate pectoralis major

Question 29

Shoulder External Rotation (Grade 4-5)

Answer 29

"push your forearm away from your stomach, hold it, don't let me move it" Stabilization: medial aspect of elbow Resistance: at dorsal surface of forearm proximal to wrist toward the trunk

Question 30

Shoulder External Rotation (Grade 0-2)

Answer 30

"try to push your forearm away from your stomach" One hand: stabilizes outside of flexed elbow Other hand: palpates the infraspinatus/teres minor

Question 31

Shoulder Internal Rotation (Grade 4-5)

Answer 31

"pull your forearm toward your stomach, hold it, don't let me pull it out" Stabilization: outside of elbow Resistance: volar surface of forearm just proximal to the wrist away from the trunk

Question 32

Shoulder Internal Rotation (Grade 0-2)

Answer 32

"try to pull your forearm away from your stomach" One hand: stabilizes forearm Other hand: palpate subscapularis tendon deep in tendon

Question 33

Elbow Flexion (Grade 4-5)

Answer 33

"bend your elbow, hold it, don't let me pull it down" Stabilization: place over anterior surface of shoulder and applies counterforce by resisting upper arm movement Resistance: contoured over flexor surface of forearm just proximal to wrist

Question 34

Elbow Flexion (Grade 0-2)

Answer 34

"try to bend your elbow" One hand: support test arm at elbow Other hand: palpate elbow flexor tendons

Question 35

Elbow Extension (Grade 4-5)

Answer 35

"straighten the elbow, hold it, don't let me bend it" One hand: underneath arm just above elbow to support Other hand: downward resistance on distal dorsal surface of extended forearm just proximal to wrist

Question 36

Elbow Extension (Grade 2)

Answer 36

"try to straighten your elbow" One hand: support limb at elbow Other hand: palpate the triceps on posterior surface just proximal to olecranon process

Question 37

Elbow Extension (Grade 0-1)

Answer 37

"try to straighten your elbow" One hand: support limb under forearm Other hand: palpate the triceps on posterior surface just proximal to olecranon process

Question 38

Forearm Supination (Grade 4-5)

Answer 38

"turn your palm up, hold it, don't let me turn it down" One hand: supports elbow Resistance: apply with heel of hand over dorsal surface at wrist

Question 39

Forearm Supination (Grade 2-3)

Answer 39

"turn your palm up" Grade 2: completes partial ROM Grade 3: completes full ROM without resistance

Question 40

Forearm Supination (Grade 0-1)

Answer 40

"try to turn your palm up so it faces the ceiling" One hand: support forearm just distal to elbow Other hand: palpate supinator distal to head of radius on dorsal aspect of forearm

Question 41

Forearm Pronation (Grade 4-5)

Answer 41

"turn your palm down, hold it, don't let me turn it up" One hand: support elbow Resistance: applied with hypothenar eminence over radius on the volar surface of the forearm at the wrist

Question 42

Forearm Pronation (Grade 2-3)

Answer 42

"turn your palm down" Grade 2: completes partial ROM Grade 3: completes full ROM without resistance

Question 43

Forearm Pronation (Grade 0-1)

Answer 43

"try to turn your palm down" One hand: support forearm just distal to the elbow Other hand: palpate pronator teres over upper third of volar surface of forearm

Question 44

Wrist Flexion (All) (Grades 4-5)

Answer 44

"bend wrist, hold it, don't let me pull it down" Stabilize: support forearm under wrist Resistance: on volar (palmar) surface of hand using four fingers in a straight down direction

Question 45

Wrist Flexion (Flexor Carpi Radialis) (Grade 4-5)

Answer 45

"bend your wrist, hold it, don't let me pull it down" Stabilize: support forearm under wrist Resistance: applied on volar surface of hand using four fingers in the direction of extension and ulnar deviation

Question 46

Wrist Flexion (Flexor Carpi Ulnaris) (Grade 4-5)

Answer 46

"bend your wrist, hold it, don't let me pull it down" Stabilize: support forearm under wrist Resistance: applied on volar surface of hand using four fingers in direction of extension and radial deviation

Question 47

Wrist Flexion (Grade 2)

Answer 47

"bend your wrist, keeping your fingers relaxed" | One hand: support forearm proximal to wrist

Question 48

Wrist Flexion (Grade 0-1)

Answer 48

"try to bend your wrist, relax, bend it again" One hand: support wrist in flexion Other hand: palpate wrist flexor tendons with index finger

Question 49

Wrist Extension (Grades 4-5)

Answer 49

"extend your wrist, hold it, don't let me push it down" | Resistance: on dorsal side using four fingers in direction in a downward direction

Question 50

Wrist Extension (Grade 2)

Answer 50

"bend your hand back" | One hand: support patient's wrist

Question 51

Wrist Extension (Grade 0-1)

Answer 51

"try to lift your hand" One hand: support wrist in extension Other hand: palpate wrist extensors on dorsal side