MMT Shoulder

Question 1

when is MMT not used

Answer 1

when a pt has an upper neuron disorder

Question 2

what MMT do we used

Answer 2

the break test

@ the end of available ROM or at a point in the ROM where the muscle is most challenged

the pt is asked to hold the part at that point and not allow the examiner to “break” the hold with manual resistance

Question 3

MMT

Answer 3

the application of manual resistance against an actively contracting muscle (against the direction of the movement as if to prevent that movement)

Question 4

what do the scores represent in the break test

Answer 4

the performance of all muscles that perform that motion

Question 5

grade range

Answer 5

0-5

zero-normal

Question 6

criteria for assigning a muscle grade

Answer 6

there is both subjective and objective info

Question 7

subjective

Answer 7

plays a larger role

examiners impression of how much resistance to apply

the actual amount of resistance a pt can tolerate

Question 8

objective

Answer 8

ability to complete full ROM

hold the position once there

ability to move against gravity or inability to move the part at all

Question 9

grade 5

Answer 9

normal

complete a full ROM against gravity and maintain end range against maximum resistance provided by the examiner

implied normal function

Question 10

grade 4

Answer 10

good

able to complete full ROM against gravity and can tolerate moderate resistance w/o breaking the test position

muscle will “give” or yield” to some extent at the end range with maximum resistance

Question 11

grade 3

Answer 11

fair

muscle or muscle group can complete full ROM against only the resistance of gravity

no resistance

yields/gives right away w/ resistance

Question 12

grade 2

Answer 12

poor

a muscle that can complete the full ROM in a position that minimizes the force of gravity

Question 13

gravity minimized position

Answer 13

put into if the pt cannot complete full ROM against gravity

in this position the PT will support the weight of the arm

slight resistance will be applied in some circumstances

Question 14

grade 1

Answer 14

trace

examiner can detect visually or by palpation some contractile activity in one or more of the muscles that participate in the movement being tested

there is no movement of the part as a result of this minimal contractile activity

Question 15

grade 0

Answer 15

zero

the muscle is completely inactive on palpation or visual inspection

Question 16

4+

Answer 16

muscle can complete full ROM against gravity and the pt can hold the position against more than moderate resistance

Question 17

3+

Answer 17

muscle can complete full ROM and pt can hold the position against slight resistance

Question 18

2+

Answer 18

can complete full ROM in gravity minimized position and holds against slight resistance

OR

muscle can complete less than half of full ROM against gravity

Question 19

2-

Answer 19

muscle can complete partial ROM in the gravity minimized position

Question 20

where do you apply resistance for 1 joint muscles

Answer 20

applied at end ROM

Question 21

where do you apply resistance for 2 joint muscles

Answer 21

applied at approximate mid range

Question 22

where is point of resistance on an extremity

Answer 22

applied near the distal end of the segment which the muscle attaches

Question 23

2 exceptions

Answer 23

hip abductors

scapular muscles

Question 24

hip abductors

Answer 24

give resistance down at the ankle

Question 25

scapular muscles

Answer 25

give resistance on the humerus but pay attention to what the scapula does

Question 26

how should resistance be applied

Answer 26

slowly and gradually

allowing it to build to the maximum tolerable intensity

Question 27

how do you start MMT

Answer 27

passive ROM followed by pt doing AROM

Question 28

shoulder flexion muscles

Answer 28

anterior deltoid

coracobrachialis

pec major

Question 29

gravity minimized position for shoulder flexion

Answer 29

side lying

support weight of arm

if can support slight resistance –> 2+

cant –> 2

Question 30

substitutions shoulder flexion

Answer 30

lateral flexion

shoulder shrug

moving out of the plane

extension of the spine

Question 31

shoulder extension muscles

Answer 31

latissimus dorsi

posterior deltoid

teres major

Question 32

gravity minimized position shoulder extension

Answer 32

there isn’t one

any ROM against gravity is a 2 (dont have to support their arm)

Question 33

shoulder extension substitutions

Answer 33

going out of plane

trunk rotation

ABD

Question 34

pt position shoulder flexion

Answer 34

short sitting

Question 35

pt position shoulder extension

Answer 35

prone with arms at sides

palm up

no pillow

head to same side

Question 36

shoulder ABD muscles

Answer 36

middle deltoid

supraspinatus

long head of biceps if in ER

Question 37

gravity minimized position shoulder ABD

Answer 37

supine

arm supported by PT

have them do 90 degrees of ABD

apply slight resistance

tolerable –> 2+

can’t –> 2

Question 38

substitutions of shoulder ABD

Answer 38

moving trunk out of plane

trunk flexion

shoulder rotation

shoulder elevation

Question 39

pt position shoulder ABD

Answer 39

short side with arm at side

elbow slightly flexed

Question 40

shoulder horizontal ABD muscles

Answer 40

posterior deltoid

middle deltoid

Question 41

gravity minimized position for horizontal ABD

Answer 41

sitting on edge of table supporting the weight of the arm

start in ADD and ask them to move their arm backward

apply resistance at end of ROM

tolerated –> 2+

can’t –> 2

Question 42

substitutions of shoulder horizontal ABD

Answer 42

trunk rotation

dropping down into ADD

elbow extension

coming out of plane of motion

Question 43

pt position of shoulder horizontal ABD

Answer 43

prone

shoulder ABD to 90

elbow at 90