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    MMT Elbow Extension by Sir DR Usama

    Uploaded by

    Usama Sohail
    This document provides instructions for performing manual muscle testing of the triceps muscle. It describes the positioning of the patient and therapist for testing elbow extension in grades 5 through 0. For each grade, it explains the test procedure and criteria for grading strength on a scale from normal (grade 5) to no muscle activity (grade 0). Helpful hints are provided, such as avoiding hyperextension and considering shoulder position when grading in the prone position. An alternate testing position is described for grades 5 through 3.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    MMT Elbow Extension by Sir DR Usama

    Uploaded by

    Usama Sohail
    21 views17 pages
    This document provides instructions for performing manual muscle testing of the triceps muscle. It describes the positioning of the patient and therapist for testing elbow extension in grades 5 through 0. For each grade, it explains the test procedure and criteria for grading strength on a scale from normal (grade 5) to no muscle activity (grade 0). Helpful hints are provided, such as avoiding hyperextension and considering shoulder position when grading in the prone position. An alternate testing position is described for grades 5 through 3.

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    MMT Elbow Extension by Sir Dr Usama

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    This document provides instructions for performing manual muscle testing of the triceps muscle. It describes the positioning of the patient and therapist for testing elbow extension in grades 5 through 0. For each grade, it explains the test procedure and criteria for grading strength on a scale from normal (grade 5) to no muscle activity (grade 0). Helpful hints are provided, such as avoiding hyperextension and considering shoulder position when grading in the prone position. An alternate testing position is described for grades 5 through 3.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    21 views17 pages

    MMT Elbow Extension by Sir DR Usama

    Uploaded by

    Usama Sohail
    This document provides instructions for performing manual muscle testing of the triceps muscle. It describes the positioning of the patient and therapist for testing elbow extension in grades 5 through 0. For each grade, it explains the test procedure and criteria for grading strength on a scale from normal (grade 5) to no muscle activity (grade 0). Helpful hints are provided, such as avoiding hyperextension and considering shoulder position when grading in the prone position. An alternate testing position is described for grades 5 through 3.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 17

    Manual Muscle PSRD College – Dr.

    Usama Sohail (UHS)

    Testing

    Elbow Extension
    Prepared by:

    Dr. Usama Sohail


    DPT - RLMC (UHS)
    MS.SPT - RIU*
    PSRD College – Dr. Usama Sohail (UHS)
    PSRD College – Dr. Usama Sohail (UHS)
    PSRD College – Dr. Usama Sohail (UHS)
    PSRD College – Dr. Usama Sohail (UHS)

    Triceps Strengthening
    PSRD College – Dr. Usama Sohail (UHS)
    PSRD College – Dr. Usama Sohail (UHS)

    Muscle Origin Insertion


    Triceps brachii All heads have a common
    • Long head • Scapula (infraglenoid tuberosity and tendon to: Ulna (olecranon
    capsule of glenohumeral joint) process, upper surface)
    • Lateral head • Humerus (shaft, oblique ridge, posterior • Blends with antebrachial
    surface) fascia
    • Lateral intermuscular septum
    • Medial head • Humerus (shaft: entire length of • Capsule of elbow joint
    posterior surface)
    • Medial and lateral intermuscular Septa

    Anconeus
    PSRD College – Dr. Usama Sohail (UHS)
    PSRD College – Dr. Usama Sohail (UHS)
    PSRD College – Dr. Usama Sohail (UHS)

    Grade 5, Grade 4 and Grade 3


    Position of Patient: Prone on table. The patient starts the test with the
    arm in 90° of abduction and the forearm flexed and hanging vertically over
    the side of the table.
    Position of Therapist: For the prone patient, the therapist provides
    support just above the elbow. The other hand is used to apply downward
    resistance on the dorsal surface of the forearm.
    Test: Patient extends elbow to end of available range or until the forearm is
    horizontal to the floor. Do not allow the patient to hyperextend or lock
    elbow while providing resistance.
    Instructions to Patient: "Straighten your elbow. Hold it. Don't let me bend
    it." Do not allow hyperextension.
    PSRD College – Dr. Usama Sohail (UHS)

    Grading
    Grade 5 (Normal): Completes
    available range and holds firmly
    against maximal resistance.
    Grade 4 (Good): Completes
    available range against strong
    resistance, but there is a "give" to
    the resistance at the end range.
    Grade 3 (Fair): Completes
    available range with no manual
    resistance.
    PSRD College – Dr. Usama Sohail (UHS)

    Grade 2, Grade 1 and Grade 0


    Position of Patient: Short Sitting. The arm is abducted to
    90 degree with the shoulder in neutral rotation and the
    elbow flexed to about 45 degree. The entire limb is
    horizontal to the floor.
    Position of therapist: Standing at test side:
    For the Grade 2 test, support the limb at the elbow.
    For a Grade 1 or Grade 0 test, support limb under the
    forearm and palpate triceps on posterior surface of the
    arm just proximal to olecranon process.
    Test: Patient attempts to extend the elbow.
    Instruction to patient: “ try to straighten your elbow.”
    PSRD College – Dr. Usama Sohail (UHS)

    Grading
    Grade 2 (Poor): Completes available range in
    the absence of gravity.
    Grade 1 (Trace): Examiner can feel tension in
    the triceps tendon just proximal to the
    olecranon or contractile activity in the muscle
    fibers on the posterior surface of the arm.
    Grade 0 (Zero): No evidence of any muscle
    activity.
    PSRD College – Dr. Usama Sohail (UHS)

    Helpful Hints
    • The therapist should confirm that muscle activity is seen and
    felt (i.e., triceps activity is actually present) because patients
    can become very adept at substituting. In fact, patients
    frequently are taught substitution and encouraged to use it as a
    functional movement, but are not allowed to do so for the
    purpose of testing.
    • Give resistance in Grade 5 and Grade 4 tests with the elbow
    slightly flexed to avoid enabling the patient to "lock" the elbow
    joint by hyperextending it.
    • While elbow extension is tested in the prone position, there
    must be awareness that with the shoulder horizontally
    abducted the two-joint muscle is less effective, and the test
    grade may be lower than it should be.
    PSRD College – Dr. Usama Sohail (UHS)

     An alternate position for Grades 5, 4, and


    3 is with the patient short sitting. The
    examiner stands behind the patient,
    supporting the arm in 90° of abduction just
    above the flexed elbow. The patient
    straightens the elbow against the
    resistance given at the wrist.
    PSRD College – Dr. Usama Sohail (UHS)
    PSRD College – Dr. Usama Sohail (UHS)

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