FUN COMPETENCY: MMT

Trunk Flexion Primary Movers

• Rectus Abdominis

• Internal Oblique

• External Oblique

Trunk Flexion PT Instructions

• Stand at side of table at level of patients CHEST to ascertain whether scapulae clear during test

• Ask patient to lift head, shoulders, & back off table; KEEPING chin pointed towards ceiling

Trunk Flexion Weakness vs. No Weakness

• NO Weakness: PT does not need to touch patient

• WEAKNESS: if patient has weak hip flexors, therapist should stabilize pelvis by leaning across patient’s forearms

Trunk Flexion Verbal Cues (G5)

• Keep your chin pointed towards the ceiling and lift your head, shoulders, & back off table

Trunk Flexion Patient Position

• Supine with legs straight & fingertips lightly touching the back of head

Trunk Rotation Primary Movers

• Internal Obliques

• External Obliques

Trunk Rotation PT Instructions

• Stand at patients waist level

• Ask patient to lift head & shoulders moving elbow to opposite hip

• REPEAT ON OTHER SIDE

Trunk Rotation Verbal Cues (G5)

• With chin pointed towards ceiling, lift your head & shoulders from the table, taking your right elbow towards your left knee

  • Return to starting position & repeat

  • Taking your left elbow to your right knee

Trunk Rotation Patient Position

• Supine with fingertips to the side of head

Trunk Rotation Palpation

• When patient rotates to one side

  • internal oblique muscle = palpated on side towards the turn

  • External oblique muscle = palpated on side away from direction of turning

Scapular Adduction Primary Movers

• Trapezius (middle fibers)

• Rhomboid Major

Scapular Adduction PT Instructions

• Stabilize contralateral scapular area to prevent trunk rotation

• Ask patient to lift elbow toward the ceiling (Grade 3)

• If able to complete full ROM, proceed to apply resistance in test position in DOWNWARD direction

• Palpate middle fibers of trapezius @ spine of scapula from acromion TO vertebral column with ffingers on other hand if necessary

Scapular Adduction Verbal Cue

• Lift your elbow towards the ceiling

• Hold it, don’t let me push it down

FOR GRAVITY MINIMIZED POSITION: “try to lift your elbow toward the ceiling”

Scapular Adduction Patient Position (G5-3) vs. (G2-1)

Prone: on stomach with arm at 90 degree angle off the table (G5-3)

Prone with arms supported (G2-1)

Shoulder Horizontal Adduction Primary Mover

• Pectoralis major

Shoulder Horizontal Adduction PT Instructions

• stand at side of shoulder to be tested

• Ask patient to move arm with elbow, flexed in horizontal adduction, keep parallel to floor without rotation, check ROM

• ** Therapist hand = used for resistance, contoured around upper arm, proximal to elbow, allowing forearm to hang free

  • RESISTANCE IS APPLIED in OPPOSITE DIRECTION OF THE TRUNK IN TRANSVERSE PLANE

Shoulder Adduction Verbal Cues BOTH HEADS

• Move your arm across your chest, hold it, don’t let me pull it back

Shoulder Adduction Verbal Cue CLAVICULAR HEAD

• Move your arm up and in

Shoulder Adduction Verbal Cue STERNAL HEAD

• Move your arm down and in

Shoulder Adduction Patient Position WHOLE MUSCLE

• Supine

• Shoulder abducted to 90 Degrees

• Elbow flexed to 90 degrees

(g5-3)

Shoulder Adduction Patient Position CLAVICULAR HEAD

• Supine

• Shoulder in 60 Degrees of ABDUCTION

• Elbow flexed to 90 Degrees

(G5-3)

Shoulder Adduction Patient Position STERNAL HEAD

• Supine

• Shoulder in 120 degrees of abduction

• Elbow flexted 90 Degrees

(G5-3)

Shoulder Adduction Patient Position (G2-1)

• Supine

• Arm is supported in 90° of abduction with elbow flexed to 90° 

• Stand at side of shoulder to be tested. If the patient is supine

• support  the full length of the forearm and hold the limb at the wrist

• **Palpate the pectoralis major muscle on the anterior aspect of the chest medial to the shoulder joint  

Shoulder External (Lateral) Rotation Primary Movers

• Infraspinatus

• Teres Minor

Shoulder External (Lateral) Rotation PT Instructions

• Stand in front of patient

• Ask patient to move the forearm away from the trunk. 

• One hand stabilizes the medial aspect of the elbow and the other hand provides resistance at the dorsal (extensor) surface of the forearm, just proximal to the wrist to avoid eliciting the wrist extensors. 

• Resistance is given on the outside of the forearm towards the trunk. 

Shoulder External (Lateral) Rotation Verbal Cue

G5-4: Push forearm away, hold it, don’t let me move it

G3: Move your forearm away from your stomach