Manual Muscle Test

MANUAL MUSCLE TEST
(MMT)
Duru Çelenoğlu
1903614
◦ Break testing in manual muscle testing, is when
resistance is applied to the body part at the end of the
available range of motion. It's called the break test
because when a therapist provides resistance the Break Test
objective for the patient is to not allow the therapist to
"break" the muscle hold.
Grading
GRAVITY RESISTED
TESTS
(GRADE 3-5)
Muscles Involved:
Deltoid (middle)
Supraspinatus
Patient actively abducts the shoulder[1] Shoulder

For grades 4-5 therapist to provide resistance over distal
humerus in the direction opposite to shoulder abduction in
Abduction
the scapular plane.
◦ Video; https://youtu.be/FoYJpoyKaK4
Muscles Involved:
Psoas Major
Iliacus
Rectus femoris
Hip Flexion
Patient actively flexes the hip
For grades 4 to 5 apply resistance over the distal femur in a
direction opposite to flexion.
◦ Video; https://youtu.be/4VIuVO_VHIs
Muscles Involved:
Tibialis Anterior
Extensor Digitorum Longus
Peroneus Tertius
Extensor Hallucis Longus Ankle
Dorsiflexion
Patient to actively dorsiflex
Grades 4 and 5: therapist to give resistance to dorsiflexion
and slight inversion movement (this is the action of the main
dorsiflexor tibialis anterior)
◦ Video; https://youtu.be/cA30-7rtWhU
Muscles Involved:
Biceps Brachii
Brachialis
Brachioradialis
Elbow Flexion
Patient is to flex the elbow
Grades 4 and 5 with resistance over flexor surface at the
distal forearm with force in the direction opposite to flexion.
◦ Video; https://youtu.be/Kyv9WjdtBSU
Muscles Involved:
Quadriceps
Patient actively extends the knee

Knee Extension
For grades 4 to 5 apply resistance through the distal tibia and
fibula in a direction opposite to extension.
◦ Video; https://youtu.be/Mjn4vI2fMnk
Muscles Involved:
Peroneus Longus
Peroneus Brevis
Ankle Eversion
Patient actively everts
For grades 4 and 5: therapist to give resistance towards
inversion & slight dorsiflexion.
◦ Video; https://youtu.be/nkWhcS7lek4
Muscles Involved:
Triceps Brachii
Anconeus
Elbow Extension
Patient is to extend elbow to full available range
Grades 4 and 5 - The therapist will apply resistance over the
dorsal forearm in the direction opposite to extension.
◦ Video; https://youtu.be/rAidhsCC6qc
Muscle Involved:
Pronator Teres
Pronator Quadratus
From the Supination patient begins to pronate until the palm

faces downward. The resistance motion applied by the Forearm
therapist is in the direction of Supination. To test Grade 3 no
resistance is given, for Grade 4 minimum resistance is given Pronation
and for 5 maximum resistance is given.
Complete available range of motion and hold maximum
resistance for grade 5. Complete available range of motion
and hold moderate to minimum resistance for grade 4.
Complete available range of motion without resistance.
◦ Video; https://youtu.be/vPK6EizlYhM
Muscles Involved:
Supinator
Biceps Brachii
From the pronation patient begins to supinate until the palm Forearm
faces the ceiling. The resistance motion applied by the
therapist is in the direction of Pronation. To test Grade 3 no Supination
resistance is given, for Grade 4 minimum resistance is given
and for 5 maximum resistance is given.
Patient supinate the forearm through partial range of motion
in the above given patient postion.
◦ Video; https://youtu.be/JMAwkfnwkOk
Muscles Involved:
Gluteus Medius
Gluteus minimus
Hip Abduction
Patient actively abducts the hip
For grades 4 and 5 provide resistance over lateral knee in the
direction opposite to abduction
◦ Video; https://youtu.be/voRkP-xTwDY
Muscles Involved:
Adductor Magnus
Adductor Brevis
Adductor Longus
Pectineus
Gracilis
Hip Adduction
Patient actively adducts the hip
For grades 4 and 5 provide resistance over the medial femur
in the direction opposite to adduction.
◦ Video; https://youtu.be/ut74xmlSEfY
Muscles Involved:
Gluteus Maximus
Semitendinosus
Semimembranosus
Biceps Femoris Hip Extension
Patient actively extends the hip
For grades 4 to 5 apply resistance through distal thigh in the
direction opposite to hip extension.
◦ Video; https://youtu.be/RdVZnPtmsUk
Muscles Involved:
Gluteus Minimus (anterior fibres)
Gluteus Medius (anterior fibres)
Tensor Fasciae Lata Hip Internal
Rotation
Patient actively internally rotates the hip
For grades 4 to 5 apply resistance through the lateral ankle
through range in a direction opposite to internal rotation.
◦ Video; https://youtu.be/zneTFTMZyCU
Muscles Involved:
Biceps femoris
Semitendinosus
Semimembranosus
Knee Flexion
Patient actively flexes the knee through range.
For grades 4 to 5 apply resistance through the distal tibia and
fibula in a direction opposite to flexion To satisfy grade 5
'normal muscle' performance criteria.
◦ Video; https://youtu.be/UrC7uJ-PRPY
Muscles Involved:
Trapezius (upper)
Levator scapulae
Scapula
Patient actively elevates scapula Elevation
For grades 4 and 5: therapist to give resistance downwards in
the direction opposite to elevation.
◦ Video; https://youtu.be/Hjg95YQc4xw
Muscles Involved:
Trapezius (middle)
Rhomboid major
Patient to perform scapula adduction "lift tip of elbow Scapula

towards the ceiling"
For grades 4 to 5, provide resistance over distal humerus in
Adduction
the direction opposite to scapular adduction.
◦ Video; https://youtu.be/VXdOn39udVA
Muscles Involved:
Latissimus Dorsi
Deltoid (posterior)
Teres Major Shoulder
Extension
Patient actively extends the shoulder through available range
For grades 4 to 5 apply resistance over posterior surface of
distal humerus in a direction opposite to extension.
◦ Video; https://youtu.be/HJO9CV-G84c
Muscles Involved:
Deltoid (anterior)
Coracobrachialis
Shoulder Flexion
Patient to actively flex the shoulder to 90 degrees
For grades 4 to 5 apply resistance over distal humerus just
above the elbow in the direction opposite to shoulder flexion.
◦ Video; https://youtu.be/XVW9_OTRzb8
Muscles Involved:
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
Wrist Extension
Patient actively extends the wrist through range.
For grades 4 to 5 apply resistance through dorsal aspect of
hand in a direction opposite to extension.
◦ Video; https://youtu.be/bjxCvDePajk
Muscles Involved:
Flexor carpi radialis
Flexor carpi ulnaris
Wrist Flexion
Patient actively flexes the wrist through range.
For grades 4 to 5 apply resistance through palm in a direction
opposite to flexion.
◦ Video; https://youtu.be/Mj989syy1Ic
GRAVITY ELIMINATED
TESTS (2-0)
◦ https://youtu.be/dxSA8bXUW9M Hip Flexion
◦ https://youtu.be/HlcbuY0dNe4
Ankle
Dorsiflexion
◦ https://youtu.be/rhJXmJpU0zw Elbow Flexion
◦ https://youtu.be/ahLelmLZXJ0 Knee Extension
◦ https://youtu.be/zK0L42UHUfU Ankle Eversion
◦ https://youtu.be/i7xrJytnchU Elbow Extension
◦ https://youtu.be/D7nsJhWP7q0
Forearm
Pronation
◦ https://youtu.be/iGFIrSN74pk
Forearm
Supination
◦ https://youtu.be/Wi-zjgT46Ok
Hip Abduction
and Adduction
◦ https://youtu.be/Z9KCJMW144c Hip Extension
◦ https://youtu.be/xyrKoEK-WtU
Hip Internal
Rotation
◦ https://youtu.be/K5Vfe1phqHU
Shoulder
Elevation
◦ https://youtu.be/383SxFBz1oE
Wrist
Exstenstion
◦ https://youtu.be/G1KBU0RBFmE Wrist Flexion
Reference;
◦ Category:Manual Muscle Testing - Physiopedia (physio-pedia.com)

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MANUAL MUSCLE TEST

Patient actively abducts the shoulder[1] Shoulder

Patient actively extends the knee

From the Supination patient begins to pronate until the palm

Patient to perform scapula adduction "lift tip of elbow Scapula

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