MMT Procedures Flashcards
Anterior neck flexors
Patient position: Supine, shoulders in 90° of abduction. elbows in 90° of flexion with hands resting near the head, palms facing up
Local position: Patient’s chin tucked to the sternum. Flex the cervical spine by lifting the head off the table. Patient instructed to hold chin tuck.
Direction of Examiner pressure: Against the forehead towards the table
Anterolateral Neck flexors
Patient Position: Supine, shoulders in 90° of abduction. elbows in 90° of flexion with hands resting near the head, palms facing up
Local Position: Rotate patient’s head towards the opposite side and add flexion of the cervical spine
Direction of examiner pressure: Press against the temples and side of patients face towards the table
Posterolateral neck extensors
Patient Position: Prone, shoulders in 90° of abduction. elbows in 90° of flexion with hands resting near the head, palms facing up
Local position: Rotate patient’s head towards the same side, extend the cervical spine
Direction of examiner pressure: Against the posterior and lateral side of the head towards the table
Upper trapezius
Patient postion: Seated with their back towards the examiner
Local position: Rotate patient’s head towards the opposite side, lateral flex and extend the cervical spine. Patient instructed to lift shoulder up towards the head
Direction of examiner pressure: Place one hand on the patient shoulder and the other hand on the side of the head, apply pressure down on the shoulder and up towards the head (as if to separate the head and shoulders)
Middle Trapezius
Patient position: Prone, patient’s head rotated towards opposite side
Local position: Shoulder abducted 90˚ with external rotation, elbow is fully extended, scapula is retracted
Direction of examiner pressure: against distal forearm towards the ground
Rhomboids and Levator Scapulae
Patient position: Prone
Local position: Shoulder is in adduction and minimal extension and external rotation, complete elbow flexion, scapula is retracted and lifted towards the head
Direction of examiner pressure: Place one hand on the back of the patients elbow, apply pressure towards shoulder flexion and abduction
Lower Trapezius
Patient position: Prone, patients head rotated to the opposite side
Local position: Shoulder abduction to 135˚ with external rotation, elbow in full extension. Patient instructed to retract and depress scapula
Direction of examiner pressure: Against forearm towards the floor
Serratus Anterior
Patient position: seated
Local position: Shoulder flexion to 120° with elbow in full extension
Direction of examiner pressure: Against distal humerus towards shoulder extension
Anterior, Middle, and Posterior Deltoid
Patient position: Seated
Local Position:
Anterior - Shoulder abducted to 90 ° with minimal flexion, Elbow flexed to 90°
Middle - Shoulder is abducted 90°, elbow flexed to 90°
Posterior - Shoulder abducted to 90 ° with minimal xtension, Elbow flexed to 90°
Direction of examiner pressure:
Anterior - Against distal humerus in the direction of shoulder adduction and extension
Middle - Against distal humerus in the direction of shoulder adduction
Posterior - Against distal humerus in the direction of shoulder adduction and flexion
Shoulder internal rotators
Patient Position: Prone with the head rotated to the opposite side
Local Position: Shoulder abduction to 90°with humerus parallel to the table, elbow flexion to 90. Patient instructed to move into maximal internal rotation
Direction of examiner pressure: Pressure applied to the distal forearm on the anterior side towards external rotation
Subscapularis and Teres Major
Patient postion: Prone with the head rotated to the opposite side
Local position: Patient places the back of hand on low back
Direction of examiner pressure: Pressure applied to the distal humerus towards shoulder abduction and flexion
Shoulder External rotators
Patient position: Prone with the head rotated to the opposite side
Local position: Shoulder abduction to 90°with humerus parallel to the table, elbow flexion to 90°, patient instructed to move into maximum external rotation
Direction of examiner pressure: Against distal forearm in the direction of internal rotation
Pectoralis Major (clavicular portion)
Patient position: Supine
Local position: Shoulder flexion to 90° with minimal internal rotation and horizontal adduction (reaching towards the opposite shoulder), elbow in full extension
Direction of examiner pressure: Against the proximal forearm pulling the arm away from the opposite shoulder towards horizontal abduction
Pectoralis major (sternal portion)
Patient position: Supine
Local position: Shoulder flexion to 135° with minimal internal rotation, shoulder horizontal adduction towards the opposite hip, elbow in full extension
Direction of examiner pressure: Against the proximal forearm, pulling the arm away from the opposite hip towards shoulder flexion and horizontal abduction
Pectoralis Minor
Patient position: supine
Local position: Palms of hands rested on the stomach. Patient instructed to lift shoulder towards the ceiling
Direction of examiner pressure: Against the anterior side of the shoulder towards the table
Latissimus Dorsi
Patient Position: Prone, patient’s head rotated towards the opposite side
Local position: Shoulder extension, internally rotation, and adduction
Direction of examiner pressure: Against distal forearm in the direction of shoulder flexion
Coracobrachialis
Patient position: seated
local position: Shoulder with minimal flexion, elbow in full flexion with supination
Direction of examiner pressure: Against distal humerus in the direction of shoulder extension and abduction
Biceps brachii
Patient position: seated
Local position: Elbow flexion to 70-90° with forearm supination
Direction of examiner pressure: Against distal forearm towards elbow extension
Brachialis
Patient Position: Supine or seated
Local position: Elbow flexion to 70-90°, pronation of forearm
Direction of pressure: Against distal forearm into elbow extension
Brachioradialis
Patient Position: supine or seated
Local Position: Elbow flexion to 70-90°, forearm is halfway between pronation and supination (dorsal side facing away from patient)
Direction of pressure: Against distal forearm into elbow extension
Triceps brachii and Anconeus
Patient Position: Supine
Local position: Shoulder flexion to 90°, minimal elbow flexion
Direction of pressure: Against distal forearm into elbow flexion
Supinator and biceps brachii
Patient position: supine
Local position: Elbow flexion to 90° with forearm supination
Direction of pressure: Examiner hand around the wrist, turning the forearm into pronation.
Pronator teres and pronator quadratus
patient position: Supine
Local position: Elbow flexion to 45°, forearm pronation
Direction of pressure: Examiner hand around the wrist, turning the forearm into supination.
Quadriceps
Patient position: Seated
Local position: knee almost in full extension
Direction of examiner pressure: Against anterior ankle into knee flexion
Hamstrings
Patient Position: Prone
Local position: Knee flexion to 50-70°, hip rotation is neutral
Direction of examiner pressure: Against distal lower leg into knee extension
Popliteus
Patient position: Seated off edge of table (knee in 90° flexion)
Local position: Patient instructed to move lower leg in and out of full external and internal rotation.
Direction of examiner pressure: no pressure applied
Gastrocnemius
Patient position: Standing with full knee extension
Local position: Patient instructed to go from foot flat position to max plantar flexion as many times as possible.
Direction of examiner pressure: No pressure applied.
5/5 = 20 full-range repetitions
4/5 = 10-19 full range repetitions
3/5 = 1-9 full range repetitions
Soleus
Patient position: Standing with minimal knee flexion
Local position: Patient instructed to go from foot flat position to max plantar flexion as many times as possible.
Direction of examiner pressure: No pressure applied.
5/5 = 20 full-range repetitions
4/5 = 10-19 full range repetitions
3/5 = 1-9 full range repetitions
Fibularis Longus and Brevis
Patient position: Supine with minimal internal rotation of the leg
Local position: Ankle plantar flexion and eversion. Heel supported off table by examiner.
Direction of examiner pressure: Against lateral aspect of foot in the direction of dorsiflexion and eversion
Tibialis Anterior
Patient position: Seated or supine
Local position: ankle dorsiflexion and inversion
Direction of examiner pressure: Against medial border of foot in the direction of plantar flexion and eversion
Tibialis Posterior
Patient position: Seated with minimal external rotation of the leg
Local position: Ankle plantar flexion and inversion
Direction of examiner pressure: Against medial side of foot in the direction of dorsiflexion and eversion
Gluteus Maximus
Patient position: Prone
Local position: Extension of hip
Direction of examiner pressure: Against distal-posterior femur in the direction of hip flexion
Gluteus Medius
Patient position: Side lying, with testing leg on top
Local position: Abduction of hip with minimal externalrotation and minimal extension, full knee extension
Direction of examiner pressure: Against distal-lateral lower leg in the direction of adduction and flexion
Gluteus Minimus
Patient position: Side lying, with testing leg on top
Local position: Abduction of hip with neutral rotation, full knee extension
Direction of examiner pressure: Against distal-lateral lower leg in the direction of adduction
Tensor Fascia Latae
Patient position: Supine
Local position: Hip in flexion with abduction and internal rotation, knee in full extension
Direction of examiner pressure: Against distal lower leg in the direction of hip extension and adduction
Hip Flexors
Patient position: Seated
Local position: Knee flexion to 90°, hip flexion to midpoint between neutral and full flexion
Direction of examiner pressure: Against anterior-distal thigh into hip extension
Psoas Major
Patient position: Supine
Local position: Knee in full extension, Hip in flexion and abduction with external rotation
Direction of examiner pressure: Against distal leg in the direction of hip extension and minimal abduction
Sartorius
Patient position: Supine
Local position: Hip flexion to 90° with external rotation and abduction, knee in flexion
Direction of examiner pressure: Examiner pushes on knee into hip extension and adduction. Examiner also pulls medial-distal lower leg in the directions of internal rotation and knee extension
Hip Adductors
Patient position: side lying
Local position: Examiner lifts and supports top leg in abduction. Patient instructed to adduct bottom leg off the table.
Direction of examiner pressure: Against distal-medial thigh of bottom leg in the direction of abduction.
Hip external rotators
Patient position: Seated (hip and knee flexion to 90°)
Local position: Hip in external rotation
Direction of examiner pressure: Against distal-medial lower leg in the direction of internal rotation
Hip internal rotators
Patient position: Seated (hip and knee flexion to 90°)
Local position: hip in internal rotation
Direction of examiner pressure: Against distal-lateral lower leg in the direction of external rotation