Muscle testing Flashcards
Resisted Isometric Testing purpose
AKA: Selective tissue tensioning
To identify tissues involved in pathology, especially contractile vs non-contractile
Resisted Isometric Testing position
Performed in the open-pack position
Limits forces placed on joint surfaces and non-contractile tissues
MMT purpose
To provide an “objective” rating of muscle strength
Method of assessing muscle strength based on individual’s ability to move body part against gravity and withstand manual resistance
MMT position
Performed in mid-range, against gravity
how to perform Resisted Isometric Testing
Force applied opposite of motion being tested
E.g. If testing elbow flexion, apply a force into extension
Resisted Isometric Testing grading
Strength: Strong or Weak
Can they resist some force
Pain: Painful or Painless
Need to grade force based on joint/motion being tested
Manual Muscle Testing: break test
Examiner is attempting to “break” the patients contraction/muscle force to determine strength
opposite direction
Manual Muscle Testing: one joint
Expect one joint muscles to
move the joint through the full ROM the muscle crosses
withstand strong external resistance at the end of completed motion
MMT multi-joint muscles
Expect multi-joint muscles to not be able to move all joints they cross through their full ROM and still be able to withstand strong resistance at the end of motion
Active insufficiency - cannot not shorten across two joints and have full ROM
Manual Muscle Testing how to prevent multiple joint issues
Prevent multi-joint muscles from over-shortening or over-lengthening
Do this by shortening over one joint and lengthening over the other
Trying to keep the muscle in the middle of its range
MMT gravity
In gravity resisted position
Gravity resisted (or antigravity) movements plane
upward in vertical plane
Gravity assisted movements plane
downward in vertical plane
Gravity minimized or reduced movements plane
in horizontal plane
like on a mat table
MMT Substitution
Muscle or muscle group’s attempt to compensate for lack of function of weak or paralyzed muscle
Muscles that normally act together may act in substitution with MMT sub
Fixating muscles
Antagonists
Other agonists
do we use in + and _ in grading scale
no - leads to confusion and inaccuracy
MMT fatigue
Does not account for fatigue
Grades of 4 and 5 MMT
can significantly underestimate the presence of a strength deficit (particularly in young, physically active people)
Isokinetic testing
moving through a ROM at certain speed
Hand-held Dynamometry
Hand-held device that allows for objective measures of muscle strength/force
Greater reliability than MMT
“Make” test
Examiner attempts to match the patient’s resistance
