UE MMT

shoulder flexion

Against-gravity position (grades 3,4,5): sitting or standing, with shoulder flexed to 90° and forearm neutral (thumb up)

stabilizing hand: superior aspect of shoulder girdle

resistive: superior aspect of distal humerus

force application: against flexion

gravity-reduced position (grade 2): side lying on non-test side; shoulder and forearm neutral

Stabilization: humerus and forearm

palpation (grade 1): anterior deltoid at anterior aspect of shoulder

shoulder extension

Against-gravity position (grades 3,4,5): prone with shoulder in midrange extension

stabilizing hand: posterior scapular

resistive hand: distal posterior humerus

force application: distal posterior humerus

gravity-reduced position (grade 2): side lying non-test side

Stabilization: humerus and forearm

palpation (grade 1): latissimus dorsi and posterior deltoid at lateral aspect of dorsal scapula

shoulder abduction

Against-gravity position (grades 3,4,5): standing or sitting, with shoulder abducted to 90°, shoulder externally rotated and forearm supinated

stabilizing hand: superior aspect of shoulder girdle

resistive hand: lateral aspect of shoulder girdle

force application: against abduction

gravity-reduced position (grade 2): supine

Stabilization: humerus and forearm

palpation (grade 1): middle deltoid at lateral aspect of shoulder; supraspinatus at superior aspect of scapula

internal rotation

Against-gravity position (grades 3,4,5): prone with shoulder abducted to 90° and elbow flexed to 90°; humerus supported with towel roll to maintain alignment with the trunk in the frontal plane; shoulder in midrange internal rotation

stabilizing hand: posterior humerus against plinth

resistive hand: volar aspect of distal forearm

force application: against internal rotation

gravity-reduced position (grade 2): standing or sitting, with upper arm against side of body and elbow flexed to 90°

Stabilization: forearm

palpation (grade 1): anterior deltoid and subscapularis anterior shoulder

external rotation

Against-gravity position (grades 3,4,5): prone with shoulder abducted 90° and elbow flexed to 90°; humerus supported with towel roll to maintain alignment with the truck in the frontal plane; shoulder in midrange external rotation

stabilizing hand: posterior humerus against plinth

resistive hand: dorsal aspect of distal forearm

force application: against external rotation

gravity-reduced position (grade 2): Standing or sitting, with upper arm against side of body and elbow flexed to 90°

Stabilization: forearm

palpation (grade 1): posterior deltoid, infraspinatus, and teres minor at posterior shoulder

elbow flexion

Against-gravity position (grades 3,4,5): standing or sitting, with elbow flexed to 90° and forearm supinated

stabilizing hand: superior aspect of shoulder girdle

resistive hand: distal forearm

force application: against flexion

gravity-reduced position (grade 2): sitting with arm supported on tabletop 90° shoulder abduction

Stabilization: humerus against tabletop

palpation (grade 1): brachialis and biceps brachii at anterior elbow

elbow extension

Against-gravity position (grades 3,4,5): supine with shoulder flexed to 90° and internally rotated; elbow flexed to 90°

stabilizing hand: distal humerus supporting shoulder in flexed position

resistive hand: distal ulnar forearm

force application: against extension

gravity-reduced position (grade 2): sitting with arm supported on tabletop in 90° shoulder abduction

Stabilization: humerus against tabletop

palpation (grade 1): triceps at posterior elbow

forearm supination

Against-gravity position (grades 3,4,5): standing or sitting, with elbow flexed to 90° and stabilized against lateral trunk; forearm neutral (thumb up)

stabilizing hand: lateral humerus stabilizing against trunk

resistive hand: lateral distal forearm; fingers grasp ulna with base of palm resisting posterior aspect of radius

force application: against supination

gravity-reduced position (grade 2): sitting with forearm on table

Stabilization: humerus against trunk

palpation (grade 1): biceps brachii at anterior elbow

forearm pronation

Against-gravity position (grades 3,4,5): standing or sitting, with elbow flexed to 90° and stabilized against lateral trunk

stabilizing hand: lateral humerus stabilizing against trunk

resistive hand: medial distal forearm; fingers grasp ulna with base of palm resisting anterior aspect of radius

force application: against pronation

gravity-reduced position (grade 2): sitting with forearm on table

Stabilization: humerus against trunk

palpation (grade 1): pronator teres at proximal aspect of radial forearm

wrist flexion

Against-gravity position (grades 3,4,5): sitting with forearm resting in supination on tabletop or forearm support; wrist in midrange flexion; fingers relaxed

stabilizing hand: mid-volar forearm stabilization against tabletop or forearm support

resistive hand: mid-volar palm

force application: against flexion

gravity-reduced position (grade 2): sitting with forearm neutral and ulnar forearm and hand resting on tabletop

Stabilization: radial forearm against tabletop

palpation (grade 1): flexor carpi radialis and flexor carpi ulnaris at volar wrist

wrist extension

Against-gravity position (grades 3,4,5): sitting with the forearm resting in pronation on tabletop or forearm support; wrist in midrange extension; fingers relaxed

stabilizing hand: mid-dorsal forearm stabilizing against tabletop or forearm support

resistive hand: dorsal metacarpals

force application: against extension

gravity-reduced position (grade 2): sitting with forearm neutral and ulnar forearm and hand resting on tabletop

Stabilization: radial forearm against tabletop

palpation (grade 1): extensor carpi ulnaris, extensor carpi radialis longus, and extensor carpi radialis brevis at dorsal wrist

wrist radial deviation

Against-gravity position (grades 3,4,5): sitting with forearm resting in neutral on tabletop or forearm support; wrist in midrange radial deviation; hand elevated or off table; fingers and thumb relaxed

stabilizing hand: radial forearm stabilizing against tabletop or forearm support

resistive hand: radial aspect of 2nd metacarpal in web space of thumb

force application: against radial deviation

gravity-reduced position (grade 2): sitting with forearm pronated and hand resting on tabletop

Stabilization: dorsal forearm against tabletop

palpation (grade 1): extensor carpi radialis longus and brevis at dorsal wrist; flexor carpi radialis at volar wrist

wrist ulnar deviation

Against-gravity position (grades 3,4,5): shoulder flexed 90°; elbow in full flexion (behind head)

stabilizing hand: on forearm for support

resistive hand: ulnar aspect of 5th metacarpal

force application: against ulnar deviation

gravity-reduced position (grade 2): sitting with forearm pronated and hand resting on tabletop

Stabilization: dorsal forearm against tabletop

palpation (grade 1): extensor carpi ulnaris at dorsal wrist; flexor carpi unlaris at volar wrist