MMT Shoulder Flashcards

1
Q

when is MMT not used

A

when a pt has an upper neuron disorder

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2
Q

what MMT do we used

A

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

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3
Q

MMT

A

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

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4
Q

what do the scores represent in the break test

A

the performance of all muscles that perform that motion

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5
Q

grade range

A

0-5

zero-normal

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6
Q

criteria for assigning a muscle grade

A

there is both subjective and objective info

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7
Q

subjective

A

plays a larger role

examiners impression of how much resistance to apply

the actual amount of resistance a pt can tolerate

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8
Q

objective

A

ability to complete full ROM

hold the position once there

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

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9
Q

grade 5

A

normal

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

implied normal function

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10
Q

grade 4

A

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

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11
Q

grade 3

A

fair

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

no resistance

yields/gives right away w/ resistance

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12
Q

grade 2

A

poor

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

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13
Q

gravity minimized position

A

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

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14
Q

grade 1

A

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

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15
Q

grade 0

A

zero

the muscle is completely inactive on palpation or visual inspection

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16
Q

4+

A

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

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17
Q

3+

A

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

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18
Q

2+

A

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

19
Q

2-

A

muscle can complete partial ROM in the gravity minimized position

20
Q

where do you apply resistance for 1 joint muscles

A

applied at end ROM

21
Q

where do you apply resistance for 2 joint muscles

A

applied at approximate mid range

22
Q

where is point of resistance on an extremity

A

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

23
Q

2 exceptions

A

hip abductors

scapular muscles

24
Q

hip abductors

A

give resistance down at the ankle

25
scapular muscles
give resistance on the humerus but pay attention to what the scapula does
26
how should resistance be applied
slowly and gradually allowing it to build to the maximum tolerable intensity
27
how do you start MMT
passive ROM followed by pt doing AROM
28
shoulder flexion muscles
anterior deltoid coracobrachialis pec major
29
gravity minimized position for shoulder flexion
side lying support weight of arm if can support slight resistance --> 2+ cant --> 2
30
substitutions shoulder flexion
lateral flexion shoulder shrug moving out of the plane extension of the spine
31
shoulder extension muscles
latissimus dorsi posterior deltoid teres major
32
gravity minimized position shoulder extension
there isn't one any ROM against gravity is a 2 (dont have to support their arm)
33
shoulder extension substitutions
going out of plane trunk rotation ABD
34
pt position shoulder flexion
short sitting
35
pt position shoulder extension
prone with arms at sides palm up no pillow head to same side
36
shoulder ABD muscles
middle deltoid supraspinatus long head of biceps if in ER
37
gravity minimized position shoulder ABD
supine arm supported by PT have them do 90 degrees of ABD apply slight resistance tolerable --> 2+ can't --> 2
38
substitutions of shoulder ABD
moving trunk out of plane trunk flexion shoulder rotation shoulder elevation
39
pt position shoulder ABD
short side with arm at side elbow slightly flexed
40
shoulder horizontal ABD muscles
posterior deltoid middle deltoid
41
gravity minimized position for horizontal ABD
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
42
substitutions of shoulder horizontal ABD
trunk rotation dropping down into ADD elbow extension coming out of plane of motion
43
pt position of shoulder horizontal ABD
prone shoulder ABD to 90 elbow at 90