lab 9

What is the purpose of gravity-minimized MMT?

Assess muscle function when the patient cannot move through full ROM against gravity

What MMT grade is typically assessed using gravity-minimized testing?

2/5 (Poor)

When should gravity-minimized testing be used?

When the patient cannot complete full ROM against gravity

Why is gravity-minimized testing clinically important?

Differentiates between severe weakness and complete paralysis

What is the primary goal of gravity-minimized positioning?

Remove the effect of gravity while allowing motion in the test plane

What MMT grade indicates full ROM in a gravity-minimized position?

2/5

What MMT grade indicates partial ROM in a gravity-minimized position?

2-/5 or poor minus (if used clinically)

What MMT grade indicates trace contraction only?

1/5

What MMT grade indicates no contraction?

0/5

How should a therapist progress after a patient demonstrates full ROM in a gravity-minimized position?

Retest against gravity for a possible grade of 3/5 or greater

Why should PROM be assessed before gravity-minimized MMT?

Ensure limited motion is due to weakness rather than ROM restriction

What equipment is commonly used for gravity-minimized testing?

Powder board, powder table, skateboard, sling suspension, or therapist support

Why are powder boards useful?

Reduce friction and minimize resistance to movement

What is the advantage of sling suspension systems?

Allow movement with minimal gravitational influence

What plane is commonly used for gravity-minimized shoulder flexion testing?

Horizontal plane with arm supported

What position is commonly used for gravity-minimized shoulder abduction testing?

Supine with arm supported on table

What position is commonly used for gravity-minimized elbow flexion testing?

Shoulder abducted with arm supported on table

What position is commonly used for gravity-minimized elbow extension testing?

Shoulder abducted with arm supported on table

What position is commonly used for gravity-minimized wrist flexion and extension testing?

Forearm supported on table in neutral position

Why must the forearm be supported during gravity-minimized wrist testing?

Prevent gravity from assisting or resisting movement

What position is commonly used for gravity-minimized hip flexion testing?

Sidelying with limb supported

What position is commonly used for gravity-minimized hip abduction testing?

Supine with limb sliding on surface

What position is commonly used for gravity-minimized hip extension testing?

Sidelying with limb supported

What position is commonly used for gravity-minimized knee extension testing?

Sidelying with limb supported

What position is commonly used for gravity-minimized knee flexion testing?

Sidelying with limb supported

What position is commonly used for gravity-minimized ankle dorsiflexion testing?

Sidelying or supported position with foot free to move

What position is commonly used for gravity-minimized ankle plantarflexion testing?

Sidelying or supported position with foot free to move

Why is proper alignment critical during gravity-minimized testing?

Small compensations can falsely suggest muscle activity

What substitution is most common during gravity-minimized testing?

Trunk movement to create apparent limb motion

Why must stabilization still be used during gravity-minimized testing?

Prevent substitution from adjacent body segments

A patient cannot actively move the arm in a gravity-minimized position but a contraction is palpated. What grade is assigned?

1/5 (Trace)

A patient completes full ROM in gravity-minimized shoulder abduction but not against gravity. What grade is assigned?

2/5 (Poor)

A patient completes partial ROM in gravity-minimized elbow flexion. What does this indicate?

Severe weakness below a full Poor grade

A patient demonstrates full ROM against gravity after previously passing gravity-minimized testing. What is the minimum possible grade?

3/5

Why is gravity-minimized testing frequently used in neurologic rehabilitation?

Patients may be too weak to move against gravity early in recovery

Which patient populations commonly require gravity-minimized testing?

Stroke, spinal cord injury, TBI, neuromuscular disease, and severe deconditioning

What is the main difference between gravity-minimized and standard MMT?

Gravity is eliminated so muscle force can be assessed without antigravity demands

Why is gravity-minimized testing valuable during early recovery?

Detects small improvements in muscle activation before antigravity movement is possible

What clinical error can occur if gravity-minimized testing is skipped?

A functioning muscle may be incorrectly graded as Trace or Zero

What is the progression of muscle performance from weakest to strongest?

0/5 → 1/5 → 2/5 → 3/5 → 4/5 → 5/5

A patient can move through full ROM on a powder board but cannot lift the limb off the surface. What grade should be assigned?

2/5

A patient demonstrates only a palpable contraction with no visible movement. What grade should be assigned?

1/5

A patient cannot move and no contraction is detected. What grade should be assigned?

0/5