Professional Documents
Culture Documents
9/13/2021/yfshih
Course objectives:
After completing this session, the students should be able to
1. Recite the origin, insertion, nerve innervation, and action of the skeletal muscles in each joint;
2. Demonstrate the ability to correctly grade muscle strength with adequate techniques; and
3. Demonstrate the ability to record and explain the result and procedure of manual muscle testing.
Evaluation:
Quiz 【參照 textbook 肌肉編號】
9/13: hip and knee joint muscles 【174-202】
9/16: foot and ankle, scapula and shoulder muscles 【124-139; 203- 225】
9/23: U/E except scapula and shoulder muscles 【140-173】
9/27: trunk muscles (cervical to lumbar) 【56-123】
9/30: facial muscles 【1-55】
Textbook: Hislop HJ, Avers D, and Brown M (2018). Daniels and Worthingham’s Muscle Testing:
Techniques of Manual Examination. 10th Edition. St. Louis, USA, Elsevier Inc..
Practicum
選擇一位有周邊神經或顏面神經損傷之病人,或其他原因造成肌力下降情形之病患,簡
述受測者病史、診斷、以及肌力檢查結果。
1
MMT
9/13/2021/yfshih
1912 Ms. Wright --- first used MMT at Dr. Lovett’s office; first publication of MMT
1917 Dr. Lovett --- method of grading muscle strength established (a scale of 0 to 6)
1925 Stewart HS --- a resistance-based grading system: maximum resistance for a normal
muscle; completing of the motion against gravity with no other resistance for a grade of
Fair.
1927 Dr. CL Lowman --- another numerical scale in muscle testing; his system covered the
effects of gravity and the full ROM on all joints and was particularly helpful for assessing
extreme weakness.
1931 Signe Brunnstrom & Marjorie Dennen --- a system of grading movement rather than
individual muscles
1932 Legg and Janet Merrill --- a comprehensive system of muscle testing; muscles were
graded on a scale of 0 to 5, and a “+” or “-“ to all grades except 1 and 0.
1936 Henry and Florence Kendall --- organize muscle testing with sound and documented
kinesiologic procedures.
2
MMT
9/13/2021/yfshih
Consideration
Test - movement
Individual muscle vs. muscle groups
Prime movers vs. accessory muscles
Agonist(s) vs. antagonist(s)
Single joint muscle vs. multi-joint muscle
Stabilization
Hand position
3
MMT
9/13/2021/yfshih
Test movement
1. To complete available end range or to hold the limb/body segment at the optimal position
for testing based on muscle length-tension relationship.
2. The therapist sometimes moves the limb/body segment to the testing position and asks the
patient to hold it.
Grading system
4
MMT
9/13/2021/yfshih
Special considerations
Substitution of movement
Available ROM (contracture, shortness / tightness, active / passive insufficiency): when
any condition limits joint range of motion, the patient can perform only within the range
available. In this circumstance, the available range is the full range of motion for that
patient at that time.
Neuromuscular condition: muscle tone, etc.
Neurological condition: cognition, etc.
Screening tests
Observation of gait, position changes, walking on the toes, gripping force, body symmetry, etc.
5
MMT
9/13/2021/yfshih