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63 Cards in this Set
- Front
- Back
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Purpose of MMT
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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)
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two main types of conventional MMT
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test in group
test specific/isolated muscle (positioning, and resistance application) |
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optimal test position for 1 joint muscle
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end ROM
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optimal test position for 2 joint muscle
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mid range
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break test
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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
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active resistance test
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requires the application of manual resistance against an actively contracting muscle or muscle group (takes skill and experience)
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application of resistance
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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)
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5 Normal
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examiner can't break the hold position
complete full ROM against gravity maximal resistance |
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4+ Good+
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complete full ROM
against gravity moderate to strong resistance |
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4 Good
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complete full ROM
against gravity moderate resistance |
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4- Good-
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complete full ROM
against gravity minimal to moderate resistance |
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3+ Fair+
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complete full ROM
against gravity minimal to slight resistance |
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3 Fair
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complete full ROM
against gravity hold test position against gravity (but no examiner resistance) |
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3- Fair-
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may complete full ROM
against gravity can't hold test position against gravity complete more than half of full ROM against gravity |
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2+ Poor+
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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 |
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2 Poor
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gravity eliminated position
complete full ROM |
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2- Poor-
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gravity elminated position
complete partial ROM |
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1 Trace Activity
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detect visually or by palpation some contractile activity
tendon becomes visible although no movement occurs |
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0 Zero (no activity)
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completely quiescent on palpation or visual inspection
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Test segment
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segment of the body that pt moves during the test, usually the segment with the insertion attachment, distal
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Test range
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part of the total jt tange that is expected to move against gravity, resistance, or friction
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Test position
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position therepist places pt to complete the desired test range
-against gravity -gravity eliminated (segment moves parallel to earth, supported) |
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stabilization
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methods used by therapist to ensure that only test segment moves
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resistance
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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 |
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MMT procedure
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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 |
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common substitutions
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another muscle with similar fxn
shoulder elevation other muscles position jt so other prime movers can perform test motion momentum avoid by good positioning, palpation, observation, and properly applied force |
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(MMT and pain)
normal |
strong and painless
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strain
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strong and painful
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significant strain or partial rupture
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weak and painful
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total rupture or neurological deficit
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weak and painless
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goniometric measurments used for
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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 |
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arthrokinematics
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movement of jt surfaces
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osteokinematics
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movement of shafts of bones
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6 steps to understanding goniometry
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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 |
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movment terminology
flexion |
bending of part so anterior surfaces from closer together
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extention
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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 |
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hyper extension
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movement in direction of extension that takes the jt beyond zero position
physiological (MCP jt) pathomechanical (knee, elbow) |
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end feel
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Soft (0-33)
firm (33-66) hard (66-100) |
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Examiner must have knowledge of
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recommended testing position
alternative position stabilization needed jt structure and fxn normal end feels anatomical bony landmarks instrument alignment |
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examiner must have skill in
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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 |
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step 1 to good goniometry
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proper and well planned positioning
start at 0* permit complete ROM provide stability avoid unnecssary moving |
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step 2
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proper stailization
keep proximal jt segment fixed during movement of distal jt component |
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step 3
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proper alignment
stationary arm - longitudinal axis of proximal segment of jt mvoing arm - longitudinal axis of distal segment of jt |
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step 4
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proper recording
subject name, age, and gender examiner name date/time of measurement make and type of goni side of body, jt and motion ROM type of motion subjective info objective info noted deviations |
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step 5
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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) |
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types of motion (from 6 steps to good goniometry)
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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) |
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factors affecting normal ROM
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age, gender(f>m), type of ROM (A or P), occupation, activities, heredity, excessive soft tissue (moon pies)
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Pathological causes for Hypomobility or hypermobility
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jt changes, capsular tightness/laxity, lig tight/lax, overstretched muscles/muscle contracture, muscle spasicity, skin contracture, blockage, pain
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Shoulder ROM
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flex - 0-180*
ext - 0-60* abd - 0-180* IR - 0-70* ER - 0-90* |
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elbow ROM
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flex - 0-150*
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wrist ROM
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flex - 0-80*
ext - 0-70* radial dev - 0-20* ulnar dev - 0-30* |
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thumb CMC
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flex - 0-15*
ext - 0-20* abd - 0-70* |
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thumb MCP
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flex - 0-50*
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thumb IP
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flex - 0-80*
ext - 0-20* |
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digit MCP
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flex - 0-90*
ext 0-45* |
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digit PIP
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flex 0-100*
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digit DIP
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flex - 0-90*
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GHJ
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ER>Abd>IR
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elbow
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flex>ext
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prox/dist radiocarpal
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pron=sup
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wrist
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equal restriction all motions
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midcarpal
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ext>flex (PF=DF)
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thumb CMC
MCP IP |
flex>ext
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