Reza Dehghani

BPT 7th sem

19BPTR186
reza19140@gcu.ac.in
Assignment Title:

• MMT Elbow and Wrist

DEFINITION OF MMT:

Manual muscle test (MMT) is a procedure for the evaluation of strength

of individual muscle or muscles group,
manual muscle testing (MMT) is a highly reliable method for assessing
strength, using a standardized clinical examination
This method involves testing key muscles from the upper and lower extremities
against the examiner’s resistance and grading the patient’s strength on a 0 to 5
scale accordingly:
1.Flicker of movement
2.Through full range actively with gravity counterbalanced
3.Through full range actively against gravity
4.Through full range actively against some resistance
5.Through full range actively against strong resistance
Performing Manual Muscle Tests
1 Elbow Flexion

Muscles Involved:
Biceps Brachii
Brachialis
Brachioradialis

Patient Positioning

•Grades 2 to 5 testing - patient is seated

•Grades 0 to 1 testing - patient is supine for 'gravity minimal' position
•Hand positioning depends on specific muscle:
• Biceps: supination
• Brachialis: pronation
• Brachioradialis: midposition
Therapist Position

•Therapist at test side

•Ensure wrist flexors are not contracting
•Palpation over intended test muscle

To Test
•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.[1]
•To satisfy grade 5 'normal muscle' performance criteria, the patient must have the ability to move
through complete range of motion (active resistance testing) OR maintain an end point range (break
testing) against maximum resistance.
https://drive.google.com/file/d/1OvwiZx2O0kSFHNeN-cynQukKal0yOwYq/view
Manual Muscle Testing:

Elbow Extension

Muscles Involved:
Triceps Brachii
Anconeus

Patient Positioning
•Prone with test side shoulder in ~90° abduction
•Patient's test side forearm is hanging over side of plinth; upper arm supported on plinth to elbow.
•For grades 0-2, the gravity minimal position is supported sitting with feet flat on the floor. The shoulder
remains in the same position.
.
Therapist Position
At test side
Provide stabilization support just above elbow

To Test
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
To satisfy grade 5 'normal muscle' performance criteria, the patient must have the ability
to move through complete range of motion (active resistance testing) OR maintain an end
point range (break testing) against maximum resistance
https://drive.google.com/file/d/1OrHjyI9f5_ZFd9j_HC9xngAnb7sCBMx2/view?usp=drivesdk
Manual Muscle Testing:

Wrist Flexion

Muscles Involved:

Flexor carpi radialis

Flexor carpi ulnaris

Patient Positioning

•Patient is seated with dorsal surface of forearm supported on table in supination

Therapist Position

•Therapist is seated to access test-side

•Palpation of wrist flexors

To Test

•Patient actively flexes the wrist through range.

•For grades 4 to 5 apply resistance through palm in a direction opposite to flexion.
•To satisfy grade 5 'normal muscle' performance criteria, the patient must have the ability to move through
complete range of motion (active resistance testing) OR maintain an end point range (break testing) against
maximum resistance.
https://drive.google.com/file/d/1OsCpUFLV4iOk1BsaZq4hx36tz3yKx4Pf/view
Manual Muscle Testing:

Wrist Extension

Muscles Involved:

Extensor carpi radialis longus

Extensor carpi radialis brevis
Extensor carpi ulnaris

Patient Positioning

Patient is seated with palmar surface of forearm supported in pronation on table,

wrist is neutral
Therapist Position

•Therapist is seated to access test-side

•Palpation of wrist extensors

To Test

•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.
•To satisfy grade 5 'normal muscle' performance criteria, the patient must have the ability to
move through complete range of motion (active resistance testing) OR maintain an end
point range (break testing) against maximum resistance.
https://drive.google.com/file/d/1Ov3uxDrWhzzQfwisIsWE8ydOqfOyhiDm/view