Practical 2_MMT Flashcards
Patient position: sitting with forearm resting in supination on tabletop or forearm support; wrist in midrange flexion; fingers relaxed
Ask patient to bring their hand to their chest
Stabilizing hand: mid-volar forearm stabilizing against tabletop or forearm support
Resistive hand: mid-volar palm
Force application (direction): against flexion
Wrist Flexion
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Gravity reduced
Patient position: sitting with forearm neutral (thumb up) and ulnar forearm and hand resting on tabletop
Stabilization: radial forearm against tabletop
Palpation: flexor carpi radialis and flexor carpi ulnaris at volar wrist
Patient position: sitting with forearm resting in pronation on tabletop or forearm support; wrist in midrange extension; fingers relaxed
Ask patient to bring their hand up towards their body/sky
Stabilizing hand: mid-dorsal forearm stabilizing against tabletop or forearm support
Resistive hand: dorsal metacarpals
Force application (direction): against extension
Wrist Extension
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Gravity reduced
Patient position: sitting with forearm neutral (thumb up) and ulnar forearm and hand resting on tabletop
Stabilization: radial forearm against tabletop
Palpation: extensor carpi ulnaris, extensor carpi radialis longus, and extensor carpi radialis brevis at dorsal wrist
Patient position: sitting with forearm resting in pronation on tabletop or forearm support; wrist in midrange ulnar deviation; hand elevated or off table; fingers and thumb relaxed
Ask patient to move their hand outward
Stabilizing hand: dorsal forearm stabilizing against tabletop or forearm support
Resistive hand: ulnar aspect of 5th metacarpal
Force application (direction): against ulnar deviation
Ulnar Deviation
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Gravity reduced
Patient position: sitting with forearm pronated and hand resting on tabletop
Stabilization: dorsal forearm against tabletop
Palpation: extensor carpi ulnaris at dorsal wrist; flexor carpi ulnaris at volar wrist
Patient position: sitting with forearm resting in neutral (thumb up) on tabletop or forearm support; wrist in midrange radial deviation; hand elevated or off table; fingers and thumb relaxed
Ask patient to move their hand inward towards body
Stabilizing hand: radial forearm stabilizing against tabletop or forearm support
Resistive hand: radial aspect of 2nd metacarpal in web space of thumb
Force application (direction): against radial deviation
Radial Deviation
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Gravity reduced
Patient position: sitting with forearm pronated and hand resting on tabletop
Stabilization: dorsal forearm against tabletop
Palpation: extensor carpi radialis longus and brevis at dorsal wrist; flexor carpi radialis at volar wrist
Patient position: sitting with hand elevated and forearm supported in pronation or propped on elbow; wrist neutral; MCP(s) flexed, PIP(s) and DIP(s) extended (intrinsic plus position)
Ask patient to push fingers against hand
Stabilizing hand: stabilizing (pinching) volar and dorsal aspects of distal metacarpal(s)
Resistive hand: volar aspect of proximal phalanx (phalanges) and dorsal aspect of middle or distal phalanx (phalanges)
Force application (direction): against flexion of the MCP joint(s) and against extension of the IP joint(s)
MCP Flexion
Patient position: sitting with hand elevated and forearm supported in pronation or propped on elbow; wrist neutral; MCPs in midrange flexion with PIPs and DIPs in relaxed flexion
Ask patient to push fingers up against hand
Stabilizing hand: stabilizing (pinching) volar and dorsal aspect(s) of distal metacarpal(s)
Resistive hand: dorsal aspect(s) of proximal phalanx (phalanges)
Force application (direction): against extension
MCP Extension
Patient position: sitting with hand elevated and forearm supported in pronation or propped on elbow; wrist neutral
Ask patient to push finger up against finger
Stabilizing hand: stabilizing (pinching) volar and dorsal aspects of distal metacarpal
Resistive hand: lateral or medial aspect of proximal phalanx relative to middle finger
Force application (direction): against abduction or adduction, depending on movement being assessed
MCP Abduction and Adduction
Patient position: sitting with hand elevated and forearm supported in supination or propped on elbow; wrist neutral; PIP being tested in mild flexion; DIP relaxed; non-test fingers held in extension
Ask patient to push finger against finger
Stabilizing hand: holding non-test fingers in extension
Resistive hand: volar aspect of middle phalanx
Force application (direction): against flexion
PIP Flexion
Patient position: sitting with forearm pronated and hand elevated on forearm support or propped on elbow; MCP and PIP extension
Ask patient to push finger up against finger
Stabilizing hand: stabilizing (pinching) volar and dorsal aspects of proximal phalanx
Resistive hand: dorsal aspect of middle phalanx
Force application (direction): against extension
PIP Extension
Patient position: sitting with hand elevated and forearm supported in supination or propped on elbow; wrist neutral; PIP extended; DIP in mild flexion
Ask patient to bend finger up against finger
Stabilizing hand: stabilizing (pinching) volar and dorsal aspects of middle phalanx
Resistive hand: volar aspect of distal phalanx
Force application (direction): against flexion
DIP Flexion
Patient position: sitting with hand elevated and forearm supported in pronation or propped on elbow; PIP and DIP extended
Ask patient to lift finger up against finger
Stabilizing hand: stabilizing (pinching) volar and dorsal aspects of middle phalanx
Resistive hand: dorsal aspect of distal phalanx
Force application (direction): against extension
DIP Extension
Patient position: sitting with the forearm and hand supported in neutral; wrist neutral; thumb resting against the lateral aspect of the 2nd metacarpal
Ask patient to bend thumb across palm
Stabilizing hand: radial aspect of distal forearm stabilizing against tabletop
Resistive hand: anterior aspect of 1st metacarpal
Force application (direction): against flexion
Thumb CMC Flexion
Patient position: sitting with forearm and hand supported in neutral; wrist neutral; thumb resting against the lateral aspect of the 2nd metacarpal
Ask patient to extend thumb out to the side
Stabilizing hand: radial aspect of distal forearm stabilizing against tabletop or forearm support
Resistive hand: posterior aspect of 1st metacarpal
Force application (direction): against extension
Thumb CMC Extension
Patient position: sitting with the forearm and hand supported in neutral; wrist neutral; thumb in mild palmar abduction
Ask patient to move thumb down and in front
Stabilizing hand: radial aspect of distal forearm stabilizing against tabletop or forearm support
Resistive hand: lateral aspect of 1st metacarpal
Force application (direction): against palmar abduction
Thumb (CMC) Palmar Abduction
Patient position: sitting with the hand elevated and forearm supported in neutral (thumb up); wrist neutral; thumb in mild radial abduction
Ask patient to move thumb up against fingers
Stabilizing hand: dorsal aspect of distal forearm stabilizing against tabletop or forearm support
Resistive hand: lateral aspect of 1st metacarpal
Force application (direction): against radial abduction
Thumb CMC Radial Abduction
Patient position: sitting with the forearm and hand supported in neutral (thumb up); wrist neutral; thumb CMC supported in neutral; thumb MCP in mild flexion
Ask patient to bend thumb against pressure
Stabilizing hand: stabilizing (pinching) volar and dorsal aspects of distal 1st metacarpal
Resistive hand: volar surface of proximal phalanx
Force application (direction): against flexion
Thumb MCP Flexion
Patient position: sitting with the forearm and hand supported in neutral (thumb up); wrist neutral; thumb CMC supported in neutral; thumb MCP extended
Ask patient to extend thumb against pressure
Stabilizing hand: stabilizing (pinching) volar and dorsal aspects of distal 1st metacarpal
Resistive hand: dorsal surface of proximal phalanx
Force application (direction): against extension
Thumb MCP Extension
Patient position: sitting with the forearm and hand supported in neutral (thumb up); wrist neutral; thumb CMC and MCP supported in neutral; thumb IP in mild flexion
Ask patient to bend thumb against pressure
Stabilizing hand: stabilizing (pinching) volar and dorsal aspects of proximal phalanx
Resistive hand: volar surface of distal phalanx
Force application (direction): against flexion
Thumb IP Flexion
Patient position: sitting with the forearm and hand supported in neutral (thumb up); wrist neutral; thumb CMC and MCP supported in neutral
Ask patient to extend thumb against pressure
Stabilizing hand: stabilizing (pinching) volar and dorsal aspects of proximal phalanx
Resistive hand: dorsal surface of distal phalanx
Force application (direction): against extension
Thumb IP Extension
Patient position: seated with hip flexed to elevate thigh from surface of plinth
Ask patient to lift their knee up
Stabilizing hand: anterior pelvis stabilizing against plinth
Resistive hand: midpoint of anterior thigh
Force application (direction): against flexion
Hip Flexion
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Gravity reduced
Patient position: side lying on non-test side, non-test hip and knee flexed to help stabilize
Stabilization: lateral hip and medial aspect of knee and lower leg
Palpation: iliopsoas (psoas major and iliacus) at anterior hip
Patient position: prone on plinth with hip in midrange extension
Ask patient to lift their leg up against pressure
Stabilizing hand: posterior aspect of pelvis stabilizing against mat
Resistive hand: midpoint of posterior thigh
Force application (direction): against extension
Hip Extension
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Gravity reduced
Patient position: side lying on non-test side, non-test hip and knee flexed to help stabilize
Stabilization: posterior hip and medial aspect of knee and lower leg
Palpation: gluteus maximus, semimembranosus, semitendinosus, and biceps femoris at posterior hip
Patient position: side lying on non-test side with hip in midrange abduction, non-test hip and knee flexed to help stabilize
Ask patient to lift their leg up against pressure
Stabilizing hand: lateral aspect of pelvis
Resistive hand: distal aspect of lateral thigh
Force application (direction): against abduction
Hip Abduction
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Gravity reduced
Patient position: supine
Stabilization: posterior aspect of thigh and lower leg
Palpation: tensor fasciae latae at lateral hip
Patient position: side lying on test leg, with non-test leg supported by practioner in abduction
Ask patient to lift their leg up against pressure
Stabilizing hand: supporting non-test leg in abduction
Resistive hand: distal aspect of medial thigh
Force application (direction): against adduction
Hip Adduction
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Gravity reduced
Patient position: supine with non-test left abducted (to allow room for test leg movement)
Stabilization: posterior thigh and lower leg
Palpation: adductor longus, adductor brevis, adductor magnus at medial aspect of proximal thigh
Patient position: sitting with hips and knees in 90 degrees flexion and legs off plinth
Ask patient to move their leg inward against pressure
Stabilizing hand: anterior thigh stabilizing against plinth
Resistive hand: distal aspect of medial tibia
Force application (direction): against external rotation
Hip External Rotation
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Gravity reduced
Patient position: supine with hip and knee supported in flexion
Stabilization: posterior aspect of distal lower leg
Palpation: gluteus maximus, piriformis, obturator internus/externus, gemellus superior/inferior at posterior aspect of hip
Patient position: sitting with hips and knees in 90 degrees flexion and legs off plinth
Ask patient to move their leg outward against pressure
Stabilizing hand: anterior thigh stabilizing against plinth
Resistive hand: distal aspect of lateral fibula
Force application (direction): medial
Hip Internal Rotation
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Gravity reduced
Patient position: supine with hip and knee supported in flexion
Stabilization: posterior aspect of distal lower leg
Palpation: gluteus medius and gluteus minimus
Patient position: prone with knee in approximately 90 degrees flexion
Ask patient to bend knee so foot touches backside
Stabilizing hand: posterior femur stabilizing against mat
Resistive hand: distal posterior tibia just proximal to ankle
Force application (direction): against flexion
Knee Flexion
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Gravity reduced
Patient position: side lying on non-test side; hip neutral
Stabilization: supporting thigh and lower leg
Palpation: semimembranosus, semitendinosus, and biceps femoris at posterior knee
Patient position: sitting with knee extended and towel roll beneath thigh for stability
Ask patient to kick knee out against pressure
Stabilizing hand: anterior thigh stabilizing against mat
Resistive hand: distal anterior tibia
Force application (direction): against extension
Knee Extension
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Gravity reduced
Patient position: side lying on non-test side; hip neutral
Stabilization: supporting thigh and lower leg
Palpation: rectus femoris, vastus intermedius, vastus lateralis, and vastus medialis proximal to patella
Patient position: prone with foot off plinth; knee extended; ankle dorsiflexed
Ask patient to push foot against pressure
Stabilizing hand: posterior tibia stabilizing leg against plinth
Resistive hand: plantar surface of foot over metatarsals
Force application (direction): against plantar flexion
Ankle Plantar Flexion
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Gravity reduced
Patient position: side lying on side to be tested, with knee extended; non-test hip and knee flexed and supported on plinth
Stabilization: lower leg elevated slightly from plinth
Palpation: gastrocnemius at proximal posterior tibia
Patient position: sitting with lower leg supported
Ask patient to push foot up against pressure
Stabilizing hand: anterior tibia
Resistive hand: dorsal surface of foot over metatarsals
Force application (direction): against dorsiflexion
Ankle Dorsiflexion
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Gravity reduced
Patient position: side lying on side to be tested, with knee flexed; non-test hip and knee flexed and supported on plinth
Stabilization: lower leg elevated slightly from plinth
Palpation: tibialis anterior at distal anterior tibia
Patient position: side lying on side to be tested, with foot off plinth; non-test leg supported with hip and knee flexed
Ask patient to push foot up against pressure
Stabilizing hand: medial tibia stabilizing against plinth
Resistive hand: medial aspect of forefoot (metatarsals)
Force application (direction): against inversion
Ankle Inversion
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Gravity reduced
Patient position: supine with ankle off plinth
Stabilization: anterior distal tibia against plinth
Palpation: tibialis posterior at posterior medial malleolus
Patient position: side lying on non-test side, with side being tested supported and off plinth
Ask patient to push foot up against pressure
Stabilizing hand: lateral lower leg
Resistive hand: lateral forefoot (metatarsals)
Force application (direction): against eversion
Ankle Eversion
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Gravity reduced
Patient position: supine with ankle off plinth
Stabilization: anterior distal tibia against plinth
Palpation: fibularis longus and brevis distal to lateral malleolus
