manual muscle testing

manual muscle testing

Manual muscle testing is a procedure for the

evaluation of the function and strength of individual
muscles and muscle groups based on the effective
performance of a movement in relation to the forces
of gravity and manual resistance.
 Conti…

 Knowledge of joint motion

 Origin and insertion of muscles
 Function of muscles and substitution patterns
 Ability to palpate the muscle or its tendon
 To distinguish between normal and atrophied
contour
 Grading parameters
Functional Classification of Muscle

 Prime Mover or Agonist

 Antagonist
 Synergist
 Fixators
 Muscles
 3 Types: Skeletal, Smooth, Cardiac
 Skeletal muscles generally voluntarily controlled

 Composed of fibers

 Work in groups
 How Do Muscles Cause Movement

 Origin- where the muscle is attached to the bone; this

bone will move very little

 Insertion- muscle attachment to bone with most

motion

 Belly of muscle- part of muscle that enlarges on

contraction
 FACTORS AFFECTING
MUSCLE STRENGTH

 Age
 Gender
 Type of muscle contraction
 Muscle size
 Speed of muscle contraction
 Previous training effect
 CONTRAINDICATIONS

 Inflammation
 Pain
 Joint instability
 Increased tone
 Grading of Manual Muscle Testing
Numeric Descriptive Grade Description
Grade
5 Normal Complete range of motion against
gravity with full resistance

4 Good Complete range of motion against

gravity with moderate resistance
3 Fair Complete range of motion against
gravity
2 Poor Complete range of motion with
gravity (gravity eliminate)
1 Trace Muscle contraction, but no or very
limited joint motion
0 Zero No evidence of muscle function
 goniometer
 Goniometer derived from Greek words,
Gonio = angle, metron = measurement

 Measurement of osteokinematic movement

 Measurement of angles created at human joints

by the bones of the body
 goniometer
 Available in a variety of sizes, shapes
 Usually constructed of either plastic or metal

 The two most common types of instruments

used to measure joint angles:
 Bubble inclinometer

 Traditional goniometer
 Bubble goniometer
 Which has a 360° rotating dial and scale with
fluid indicator can be used for
 Flexion and extension

 Abduction and adduction

 Rotation in the neck, shoulder, elbow, wrist,

hip, knee, ankle, and the spine.
 traditional goniometer
 Which can be used for flexion and extension;
abduction and adduction; and rotation in the
shoulder, elbow, wrist, hip, knee, and ankle,

Consists of three parts:

•Body
•Stationary arm
•Moving arm
 Conti…
A body
The body of the goniometer is designed like a
protractor and may form a full or half circle
A measuring scale is located around the body.
The intervals on the scales can vary from 1 to 10
degrees

A Stationary Arm
The stationary arm is structurally a part of the
body and therefore cannot move independently of
the body
 Conti…

A moving arm
The moving arm is attached to the fulcrum in the center
of the body by a rivet or screw-like device that allows the
moving arm to move freely on the body of the device.
 Joint Action Degree of Motion
Flexion 170º - 180º
Extension 50º - 60º
Abduction 170º - 180º
Shoulder Internal rotation 70º - 80º
External rotation 80º - 90º
Horizontal abduction 40º - 45º
Horizontal adduction 130º - 135º
Elbow Flexion 140º - 150º
Pronation 80º - 90º
Forearm Supination 80º - 90º
Flexion 80º - 90º
Extension 60º - 70º
Wrist Radial deviation 15º - 20º
Ulnar deviation 20º - 30º
Joint Motion Degrees
MCP: 80º - 90º
Finger Flexion PIP: 90º - 100º
DIP: 80º - 90º
MCP:40º - 45º
Finger Extension PIP: 0º
DIP: 0º
CMC: 15º - 20º
Hand Thumb Flexion MCP: 50º - 60º
IP: 70º - 80º
CMC: 20º - 30º
Thumb Extension IP: 10º actively, 30º passively

Thumb Adduction 20º

Thumb Abduction 60º - 70º

 Joint Action Degree of Motion
Flexion 120º - 130º
Extension 30º - 40º
Abduction 35º - 45º
Hip
Adduction 20º - 30º
Internal rotation 40º - 45º
External rotation 40º - 45º
Knee Flexion 135º - 140º
Plantarflexion 40º - 50º
Dorsiflexion with knee
Ankle extended 15º - 20º
Dorsiflexion with knee flexed
0º - 10º
Inversion 15º - 20º
Eversion 5º - 10º
Foot
 Motion Normal Range (Degrees)

Great toe
MTP: 45º
IP: 90º
Toe Flexion Lateral four toes
MTP: 40º
PIP: 35º
DIP: 60º
Great toe
MTP: 70º
IP: 0º
Toe Extension Lateral four toes
MTP: 40º
PIP: 0º
DIP: 30º