Lab

SPS2301 Exercise Rehabilitation: Manual Muscle Testing (MMT)

Definition: Manual strength testing is a clinical assessment technique where an examiner applies resistance to evaluate the strength and function of injured body parts. This method aids in understanding muscle capabilities following injury or surgery.
Comparison: To establish a reliable benchmark for assessment, results from the injured limb are compared against those from the non-injured limb. This comparative analysis helps in identifying the extent of weakness or dysfunction in the affected area.
Equipment: One of the key advantages of manual muscle testing is that it requires no special equipment, making it a convenient assessment tool for practitioners in various settings, including clinics and remote areas.
Subjectivity: The results of manual muscle testing can be subjective owing to the variability in examiner strength, technique, and perception. Thus, consistent practice and calibration among clinicians are essential to ensure accuracy and reliability during assessments.

Break Test: This test involves applying external resistance at the mid-range of motion, specifically targeting the assessment of isometric strength while the muscle is in a neutral position. It isolates muscle groups effectively.
MTM: Manual Muscle Testing entails applying external resistance throughout the entire range of motion (ROM), assessing both the strength and endurance of muscles during dynamic movements.

Strong and Painless: Indicates that the muscle functions effectively without any pain. This is a positive outcome frequently seen in healthy muscular systems.
Strong and Painful: Muscle can perform effectively but pain is present, suggesting potential underlying issues such as inflammation or previous injury.
Weak and Painless: Muscle exhibits a notable lack of strength, but no pain is present. This may indicate potential neurological issues or disuse atrophy.
Weak and Painful: A significant indicator of injury, this outcome shows both weakness and pain, signaling dysfunction that may require further investigation and rehabilitation.

Purpose: The primary goal of manual muscle testing is to assess muscle strength against both gravitational forces and externally applied resistance throughout the complete range of motion, with a specific focus on primary movers related to key joints such as the shoulder, hip, and knee.
Assessment Grades: Muscle strength is graded on a standardized scale from 0 to 5:
- 0 – Zero: No detectable muscle activity, indicating severe deficits.
- 1 – Trace: A slight contraction is palpable but does not result in movement.
- 2 – Poor: Movement can occur through the horizontal plane, yet the muscle cannot overcome gravity.
- 3 – Fair: Movement against gravity through the full range of motion, considered adequate strength in many rehabilitation contexts.
- 4 – Good: Movement against gravity with some additional resistance, demonstrating a higher level of muscle strength.
- 5 – Normal: Muscle exhibits the ability to move against gravity with full resistance, representing optimal muscular function.

Observation and Palpation: Essential techniques to detect muscle differences and size/contour discrepancies, allowing for a more accurate assessment of muscular health.
Positioning: Accurate positioning of the subject is paramount to reduce compensatory movements and ensure precise measurements.
Stabilization: Proper stabilization is crucial during testing to prevent substitution movements or compensatory actions that could skew test results.

It is important to note that variations in body shape, age, sex, ethnicity, and psychological factors may influence strength assessments, necessitating a tailored assessment approach.

Assessment of ROM: Begin by asking the subject to move the limb through its range of motion, aiming to achieve a Grade 3, which is indicative of fair strength.
Gradual Resistance Increase: If Grade 3 is successfully achieved, progressively increase resistance to determine if the subject can reach Grade 4. Continuing this approach, if Grade 4 is attained, apply full resistance to evaluate for Grade 5.
If Grade 3 is Not Achieved: Adjust positioning to minimize the effects of gravity, allowing for an assessment for Grade 2.
If Grade 2 is Not Achieved: Palpate the muscle in question to evaluate muscle activation and assign a Grade 1 if a trace is felt.
Final Grade: In the absence of detectable contraction, designate the muscle strength as Grade 0.

Task 1 (15 minutes): Complete the anatomical table incorporating the relevant anatomical and physiological details using the provided resources.
Task 2 (50 minutes): Perform Manual Muscle Testing for various key movements (including Knee Extension, Knee Flexion, Hip Extension, Hip Flexion, and Hip Abduction) with the following guidelines:
- Begin testing for Grade 3 strength first, then progress up to Grades 4 and 5 as applicable.
- For participants likely achieving only Grade 2, proactively strategize the positioning of the subject to minimize gravitational influence on the assessment.
- Ensure stabilization of body parts to minimize substitution movements during the tests.

Revisit Lecture Notes: Focus on the details covered in the previous week regarding neck and back rehabilitation methods and principles.
Dress Appropriately: Wear suitable attire for practical sessions to facilitate ease of movement and testing.
Assignment Reminder: Be cognizant of assignments due in approximately 4 weeks; plan your workload and commitments accordingly to ensure timely submissions.