Upper Extremity MMT

Question 1

Serratus Anterior

Scapular ABduction and Upward Rotation

Grade 3-5

Answer 1

Patient Position: sitting with arm flexed ~130 degrees
Patient Cues: “reach forwards and up” (protract scapula)
Direction of Force: push posterior and inferior throught distal humerus

Question 2

Serratus Anterior

Scapular ABduction and Upward Rotation

Grade 2

Answer 2

Patient Position: sitting with arm flexed above 90 degrees
Therapist Position:
-one hand supports weight of scapula while patient protacts scaupla
-other hand monitoring scalular motion with hand on ingerior angle of scapula

Question 3

Serratus Anterior

Scapular ABduction and Upward Rotation

Grade 0-1

Answer 3

Patient Position: seated with arm flexed above 90 degrees
Palpation: serratus anterior on lateral border of ribs 1-8

Question 4

Upper Traps & Levator Scap

Scapular Elevation

Grade 3-5

Answer 4

Patient Position: patient sitting with feet supported on floor (ensure hands are not pushing on thighs or table)
Patient Cue: “Shrug your shoulders up towards your ears”
Position of Force: straight down through shoulders

Weak Upper Traps = downward rotation
Weak Levator Scap - upward rotation

Question 5

Upper Traps & Levator Scap

Scapular Elevation

Grade 2

Answer 5

Patient Position: patient prone
- facing away from side being tested for upper traps
- facing towards side being tested for levator scap

Therapist Position: therapist supports the weight of the shoulder as the patient shrugs their shoulder towards their ear

patient must get full ROM with shoulder supported

Question 6

Upper Traps & Levator Scap

Scapular Elevation

Grade 0-1

Answer 6

Patient Position: Prone
Palpation: upper traps and levator scapulae

Question 7

Middle Trap and Rhomboids

Scapular Adduction (Retraction)

Grades 3-5

Answer 7

Patient Position: prone with shoulder ABD 90 degrees and elbow flexed 90 degrees
Patient Cues: “lift your elbow towards the ceiling and hold it”
Direction of Force: straight down through distal humerus
Stabilization: contralateral scapula

Question 8

Middle Traps and Rhomboids

Scapular Adduction (Retraction)

Grade 2

Answer 8

Patient Position: prone with shoulder ABD 90 degrees and elbow flexed 90 degrees
Therapist Position: Support weight of the arm (can palpate middle traps and rhomboids)

patient must get full ROM with arm supported

Question 9

Middle Traps and Rhomboids

Scapular Adduction (Retraction)

Grade 0-1

Answer 9

Patient Position: prone with shoulder ABD 90 degrees and elbow flexed 90 degrees
Palpation: Middle Traps and Rhomboids

Question 10

Lower Traps

Scapular Depression and Adduction

Grade 3-5

Answer 10

Patient Position: Prone with arm overhad in line of lower trap fibers (~145 elevation and ABD)

Patient Cues: “life your arm off the table)

Direction of Force: down towards the floor

For 5/5 force must be applied at distal forearm

Question 11

Lower Traps

Scapular Depression and Adduction

Grade 2

Answer 11

Patient Position: Prone with arm overhad in line of lower trap fibers (~145 elevation and ABD)

Therapist Position: support the weight of the patients arm under the elbow

2/5 if patient is able to go throught full ROM with arm supported

Question 12

Lower Traps

Scapular Depression and Adduction

Grade 0-1

Answer 12

Patient Position: Prone with arm overhad in line of lower trap fibers (~145 elevation and ABD)

Palpation: lower traps (medial spine of scapula)

Question 13

Rhomboids

Scapular Adduction (retraction) and Downard Rotation

Grade 3-5

Answer 13

Patient Position: Prone with arm behind patients back (palm up)

Patient Cues: “lift your hand and hold it”

Direction of Force: down and out rhgough distal humerus

Stabilizaion: other hand is used to palpate rhomboids under medial border of scapula

Question 14

Rhomboids

Scapular Adduction (retraction) and Downard Rotation

Grade 2

Answer 14

Patient Position: Sitting with arm behind the back
Therapist Position: therapist supports arm at proximal wrist while patient attempts to move arm away from their back
Stabilizaion: other hand is used to palpate rhomboids under medial border of scapula

2/5 patient must complete full scapular motion

Question 15

Rhomboids

Scapular Adduction (retraction) and Downard Rotation

Grade 0-1

Answer 15

Patient Position: sitting with arm behind back
Palpation: rhomboids (medial border of scapula)

Question 16

Latissimus Dorsi

Grade 3-5

Answer 16

Patient Postion: prone with arm at side and palm up. Head should be turned towards test side

Patient Cues: “raise your arm straight up and hold it”

Direction of Force: down and out through distal forearm

Question 17

Latissimus Dorsi

Grade 2

Answer 17

Patient Postion: prone with arm at side and palm up. Head should be turned towards test side

Patient Cues: “raise your arm straight up and hold it”

2/5 given if patient is able to go through partial ROM

Question 18

Latissimus Dorsi

Grade 0-1

Answer 18

Patient Postion: prone with arm at side and palm up. Head should be turned towards test side

Palpate: Latissimus Dorsi (lateral back)

Question 19

Shoulder Flexion

Grade 3-5

Answer 19

Muscles:
- anterior deltoid
- rotator cuff
- clavcular portion of pec major
- coracobrachialis

Patient Position: sitting with arm at side and forarm pronated

Patient Cues: “raise your arm up until it is in line with your shoulder”

Direction of Force: down trhough distal humerus

Stabilization: same shoulder

Question 20

Shoulder Flexion

Grade 2

Answer 20

Patient Position: sidelying
Therapist Position: supporting the weight of the arm at the elbow
Patient Cue: “try to raise your arm”

2/5 patient must get full ROM with arm supported

Question 21

Shoulder Flexion

Grade 0-1

Answer 21

Patient Position: Sidelying
Palpation: anterior delt