Muscle Performance Examination and Intervention Principles Flashcards
Isotonic Testing
Joint movement occurs against a fixed or variable load
includes (concentric) and (eccentric)
Repetition Maximum
Maximal weight a person can lift in perfect form
Requires you to determine failure or inability to complete next rep
Isokinetic Testing
Joint movement that occurs at a fixed speed
Accommodating resistance
Load is matched
quantifies fatigue or amount or rate of force decline
quantify rate of force development
Isometric Testing
No apparent motion at joint (static testing)
external load equals the force produced by the muscle
Manual techniques (MMT)
Instrumented techniques
MMT score
ordinal measurement scale
0= no muscle contraction
5= movement through complete ROM against gravity and maximal resistance
Normal (N or 5)
full available ROM against gravity
maximal manual resistance
Good (G or 4)
full available ROM against gravity
moderate manual resistance
Fair + (F+ or 3+)
Full available range of motion against gravity
minimal manual resistance
Fair (F or 3)
start here with all patients
Full available range of motion against gravity
no manual resistance
Fair - (F- or 3-)
more than half available ROM against gravity
no manual resistance
Poor + (P+ or 2+)
less than half available ROM against gravity
no manual resistance
Poor - (P- or 2-)
partial ROM in gravity minimized position
no manual resistance
Trace (T or 1)
no joint motion, gravity minimized position, muscle contraction palpable or observable
Poor (P or 2)
full available ROM in gravity minimized position
What is Subjective?
amount of resistance Patient tolerates during test
Objective
ability of patient to complete full ROM or to hold position
ability to move against gravity or inability to move at all
Break test
PT applies resistance until muscle contraction overcome by patient
More force than make test
“hold this position, dont move”
Make test
Set force level and ask patient to match it
Force lower than break test
commonly used with HHD
Intrarater
reliability is good
Interrater
reliability is fair/good
Grades above good (4)
Not strong with other strength measures
Grades below good (4)
strong relationships with other strength measures
MMT reliability depends on
muscle tested
experience/ education of tester
patients
studies
Errors affecting reliability
submaximal contractions
substitutions
report of wrong side
Strengths of MMT
always available
inexpensive
useful for individual muscles
Weakness of MMT
imprecise
reliability/validity issues
ceiling effects