Muscle Performance Assessment

Question 1

What are two reasons why there could be a huge difference in AROM and PROM in a patient?

Answer 1

Muscle weakness or pain

Question 2

_ degrees of difference between the active & passive ROM is not a REAL difference.

Answer 2

5

Question 3

If a patient does not complain of any pain during ROM testing and there is a difference in a patients AROM compared to their PROM then this difference must be attributed to what?

Answer 3

Muscle weakness

Question 4

What is step 1 of the MMT procedure?

Answer 4

Assess the available motion (PROM)

Question 5

What is step 2 of the MMT procedure?

Answer 5

Ask the patient to perform AROM vs gravity and assess if their AROM = PROM.

Question 6

What is the most common type of strength testing we do in PT?

Answer 6

MMT

Question 7

All the standard positions for MMT are done in an (against gravity/gravity minimized) position, so we are going to compare both active and passive ROMs against gravity. So we can either lift the patients arm overhead and assess their passive ROM and then ask the patient to actively raise their shoulder above their head to assess active ROM and compare, OR I can ask the patient to lift their arm over their head and when they get to their end ROM I can apply some over pressure to see if there is a real difference between the patient’s active and passive ROM.

Answer 7

against gravity

Question 8

Standard position for assessing shoulder flexion in MMT is (sitting or standing/supine) because it is against gravity, standard position for shoulder flexion ROM is (sitting or standing/supine). For goniometric measurements for shoulder flexion we don’t get much information about the person’s strength, we have to have them sitting to do MMT for that.

Answer 8

sitting or standing; supine

Question 9

In the MMT procedure, after assessing the patient’s AROM & PROM and you find that they equal each other then what happens next?

Answer 9

Manual resistance is applied

Question 10

Break test – applying stress to the joint to see at what point they will break or at what point their arm will give. Break tests are done in about the (middle/end) of the PATIENT’S AVAILABLE ROM. We apply resistance in a gradually increasing way and let the patient resist the force.
We usually try to apply force at the distal most portion of the segment that we are trying to test without crossing over multiple joints.

Answer 10

middle

Question 11

What are the MMT words for the MMT scores of 5,4,3,2,1, and 0

Answer 11

5 - Normal, 4 - good, 3 - fair, 2 - poor, 1 - trace, & 0 - zero

Question 12

A MMT grade of a _ is for anybody that has an AROM & PROM equal to one another in an against gravity position. When you compare their PROM & AROM they were equal and when you tried to apply resistance to them right away they broke.

Answer 12

3

Question 13

What is a MMT grade for a person who has full available AROM against gravity and against moderate resistance?

Answer 13

4

Question 14

Emphasize comparing the same testing to the opposite side to provide a basis of comparison about what is moderate and maximal resistance.
If I push on the patient’s left side and they seemed to break after I gave them some resistance and then I tested the other side and they could take a ton of resistance then I am confident that the side that could only take some resistance is a 4 instead of a 5.

Answer 14

Got it

Question 15

It is IMPERATIVE that if you are going to give someone a grade of a 4 or 5 you HAVE TO do what?

Answer 15

Test the other side

Question 16

What is a MMT grade for a person who has full available AROM against gravity and maximal resistance?

Answer 16

5

Question 17

What is the standard position for measuring shoulder extension?

Answer 17

Prone

Question 18

If the patient’s ACTIVE & PASSIVE ROM do not equal each other in an against gravity position, they are automatically below a grade of __.

Answer 18

3

Question 19

If the patient’s ACTIVE & PASSIVE ROM do not equal each other in an against gravity position, what do you do?

Answer 19

You put the patient in a gravity minimized position and see if they have full available ROM.

Question 20

A gravity minimized position for shoulder flexion would be what?

Answer 20

Sidelying

Question 21

What is a MMT grade for a person who has full available ROM in a gravity minimized position?

Answer 21

Poor (2)

Question 22

What is a MMT grade for a person who has palpable or observable muscle contractions present, but no movement?

Answer 22

Trace (1)

Question 23

What is a MMT grade for a person who has no palpable or observable muscle contraction?

Answer 23

Zero (0)

Question 24

When talking about reliability and validity and that sort of thing, MMT grades of (3,2,1/4s and 5s) are genuinely more reliable and valid whereas (3,2,1/4s and 5s) are a little less reliable and valid.

Answer 24

3,2,1,; 4s and 5s

Question 25

MMT grades of (3,2,1/4s and 5s) are objective, whereas MMT grades of (3,2,1/4s and 5s) are subjective

Answer 25

3,2,1; 4s and 5s

Question 26

In terms of the minus’ in MMT, what are the only two grades that will have a minus?

Answer 26

Fair - (3-) & Poor - (2-)

Question 27

What is the MMT grade for a person who has partial ROM in an against gravity position?

Answer 27

3-

Question 28

So the example of the patient who had shoulder flexion PROM of 120 and AROM of 77 would be assigned a _ instead of the 2 because they have partial ROM in an against gravity position.

Answer 28

3-

Question 29

An MMT grade of _ is greater than 50% of ROM against gravity

Answer 29

3-