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63 Cards in this Set

  • Front
  • Back
Purpose of MMT
provide quick objective evaluation of muscle strength (to propel, control, or stabilize during activities), length (allow normal movements), and endurance (enough to perform repetitive or prolonged tasks)
two main types of conventional MMT
test in group
test specific/isolated muscle (positioning, and resistance application)
optimal test position for 1 joint muscle
end ROM
optimal test position for 2 joint muscle
mid range
break test
manual resistance applied to limb or other body part after it has completed its ROM or after it has been placed at end ROM by examiner
active resistance test
requires the application of manual resistance against an actively contracting muscle or muscle group (takes skill and experience)
application of resistance
1 joint muscle is at end ROM and 2 joint muscle is at mid range, apply resistance near distal end of segment to which muscle attaches (exceptions - scapular stabilizers and hip adductors)
5 Normal
examiner can't break the hold position
complete full ROM
against gravity
maximal resistance
4+ Good+
complete full ROM
against gravity
moderate to strong resistance
4 Good
complete full ROM
against gravity
moderate resistance
4- Good-
complete full ROM
against gravity
minimal to moderate resistance
3+ Fair+
complete full ROM
against gravity
minimal to slight resistance
3 Fair
complete full ROM
against gravity
hold test position against gravity (but no examiner resistance)
3- Fair-
may complete full ROM
against gravity
can't hold test position against gravity
complete more than half of full ROM against gravity
2+ Poor+
initiate and move through partial ROM against gravity (<50% of full ROM)
gravity eliminated - complete full ROM
hold test position against minimum to slight resistance
2 Poor
gravity eliminated position
complete full ROM
2- Poor-
gravity elminated position
complete partial ROM
1 Trace Activity
detect visually or by palpation some contractile activity
tendon becomes visible although no movement occurs
0 Zero (no activity)
completely quiescent on palpation or visual inspection
Test segment
segment of the body that pt moves during the test, usually the segment with the insertion attachment, distal
Test range
part of the total jt tange that is expected to move against gravity, resistance, or friction
Test position
position therepist places pt to complete the desired test range
-against gravity
-gravity eliminated (segment moves parallel to earth, supported)
methods used by therapist to ensure that only test segment moves
applied only after pt has successfuly completed the range against gravity, check against gravity AROM first
3+/5 or better
Friction, Gravity (weight of segment), Therapist applied, weight of soft tissues
MMT procedure
expalin procedure and importance of testing, commands that will be used
get testing supplies, position table to appropriate height
position pt for comfort, stability, won't have to change
position muscle in shortened position or mid range
break test
common substitutions
another muscle with similar fxn
shoulder elevation
other muscles position jt so other prime movers can perform test motion
avoid by good positioning, palpation, observation, and properly applied force
(MMT and pain)

strong and painless
strong and painful
significant strain or partial rupture
weak and painful
total rupture or neurological deficit
weak and painless
goniometric measurments used for
determine dysfunction
establish/confirm diagnosis
develop tx goals
evaluate progress
objectively document progress for 3rd part payers
modify tx
motivate subject
research therapeutic techniques
fabricate orthoses and adaptive equipment
movement of jt surfaces
movement of shafts of bones
6 steps to understanding goniometry
1. know planes and axes
2. know anatomical position
3. understand how body mvoes from anatomical position in planes and around axes
4. correctly apply numbers to motion (o-180*)
5. know different types of motion
6. understand end feels and capsular patterns
movment terminology
bending of part so anterior surfaces from closer together
straightening of part and movement in opposite direction of flexion
denote the direction of motion that returns the jt back to zero from flexed position
hyper extension
movement in direction of extension that takes the jt beyond zero position
physiological (MCP jt)
pathomechanical (knee, elbow)
end feel
Soft (0-33)
firm (33-66)
hard (66-100)
Examiner must have knowledge of
recommended testing position
alternative position
stabilization needed
jt structure and fxn
normal end feels
anatomical bony landmarks
instrument alignment
examiner must have skill in
position and stabilize correctly
move body pt through appropriate ROM
determine end ROM and end feel
palpate appropriate bony landmarks
align goniometer with landmarks
read instrument correctly
record mersurements correctly
step 1 to good goniometry
proper and well planned positioning
start at 0*
permit complete ROM
provide stability
avoid unnecssary moving
step 2
proper stailization
keep proximal jt segment fixed during movement of distal jt component
step 3
proper alignment
stationary arm - longitudinal axis of proximal segment of jt
mvoing arm - longitudinal axis of distal segment of jt
step 4
proper recording
subject name, age, and gender
examiner name
date/time of measurement
make and type of goni
side of body, jt and motion
type of motion
subjective info
objective info
noted deviations
step 5
know contraindications (at a jt that is dislocated of extremely unstable, in a motion segment that posseess an unstable fracture, immediately after surgical procedure to tendon, lig, muscle, jt, jt capsule, or skin)
precautions (presence of infection, pt is on medication for pain or muscle relaxation, presence of marked osteoporosis or bone fragility, mild to mod instability)
types of motion (from 6 steps to good goniometry)
AROM (willingness tom ove, coordination, strength, jt ROM, movements that cause pain)
PROM (movement possible at jt, greater than AROM, integrity of articular surfaces, extensibility of jt capsule, compare to AROM, assess end feel and capsular pattern)
factors affecting normal ROM
age, gender(f>m), type of ROM (A or P), occupation, activities, heredity, excessive soft tissue (moon pies)
Pathological causes for Hypomobility or hypermobility
jt changes, capsular tightness/laxity, lig tight/lax, overstretched muscles/muscle contracture, muscle spasicity, skin contracture, blockage, pain
Shoulder ROM
flex - 0-180*
ext - 0-60*
abd - 0-180*
IR - 0-70*
ER - 0-90*
elbow ROM
flex - 0-150*
wrist ROM
flex - 0-80*
ext - 0-70*
radial dev - 0-20*
ulnar dev - 0-30*
thumb CMC
flex - 0-15*
ext - 0-20*
abd - 0-70*
thumb MCP
flex - 0-50*
thumb IP
flex - 0-80*
ext - 0-20*
digit MCP
flex - 0-90*
ext 0-45*
digit PIP
flex 0-100*
digit DIP
flex - 0-90*
prox/dist radiocarpal
equal restriction all motions
ext>flex (PF=DF)
thumb CMC