Musculoskeletal tables

Manual grading of Accesory Joint

MMT
motion
Type Grade Criteria
Grade Joint status
Normal 5 Against gravity with max resist
0 Ankylosed
Good 4 Against gravity with Mod resist
1 Considerable Hypomobility
Fair 3 Against gravity
2 Slight Hypomobility
Poor 2 Gravity eliminated plane
3 Normal
Trace 1 Flickering , palpable
4 Slight Hypermobility
zero 0 No observable or palpable
5 Considerable hypermobility
contraction
6 Unstable

www.nptestudybuddy.com Email:_ nptestudybuddy@gmail.com

 Normal End feel Abnormal end Feel

End Feel Structure Example End Structure Example

Feel

Soft Soft tissue Eg- Knee Flexion Soft Occurs sooner or Soft tissue edema or
Approximation later in ROM than is synovitis
Elbow Flexion usual; in a joint that
has firm or hard end
feel

Muscular stretch SLR (Passive elastic Firm Same Inc Muscular tone,
tension of hams) capsular tightness or
Firm ligament shortening

Capsular stretch Extension of MCP Hard Same Myositis ossificans

joint in finger
(Tension in ant Hypertrophic
capsule) Ossificans
A bony grating or
bony block is felt OA

Shoulder Extension Chondromalacia

with Elbow flexed Loose bodies in jt
(Ant capsule
tension)

Ligamentous Supination at elbow Empty No real End feel Inflammation

stretch (Inf radioulnar because pain
ligament stretched, prevents reaching bursitis
interosseous mem, end range Abscess
etc.)
Fracture
Hard Bone to bone Elbow extension
No resistance felt
except patient’s
protective resistance
mech// due to spasm

Springy end feels For Meniscus tear

www.nptestudybuddy.com Email:_ nptestudybuddy@gmail.com

 Capsular Pattern

Wrist Equal Restriction Flexion = Extension

Mid carpal Limitation Equal in all direction

Trapeziometacarpal (Thumb) Limitation Abd >>> ADD

Carpometacarpal (2-5) Limitation equal in all direction

Digits Limitation: Flexion >>>> Extension

Atlantooccipital jt FWD bending >>> Backward bending

Atlantoaxial jt Rotational restriction

Lower cervical C3- T2 Side bending & rotation >>>>> Extension…… NO limitation in
flexion

Thoracic spine Limitation: Side bending and rotation >>> Extension>>>Flexion

Lumbar spine Marked limitation in side bending n rotation; Extension loss

>>>Flexion

SI, symphysis pubis, Sacrococcyxeal Pain when joints are stressed

Talocrural Limitation: PF >>> DF

Talocalcaneal Varus >>>> Valgus (Joint fixed in valgus)

Midtarsal Supination >>> Pronation (Limited Add, Medial rotation, PF n

DF)

1st Metatarsophalangeal Limitation Extension >>>>> Flexion

2-5 Metatarsophalangeal Tend towards flexion restrict

Interphalangeal Tend towards Extension restriction

www.nptestudybuddy.com Email:_ nptestudybuddy@gmail.com