Category:Manual Muscle Testing: Difference between revisions

This category includes all pages on manual muscle testing and specifically manual muscle testing by muscle group.

'Resistance' in manual muscle testing is always a concentric force provided by the therapist in the direction opposite to the contracting muscle or muscles.

As per Daniels and Worthington's book 'Muscle Testing: Techniques of Manual Examination and Performance Testing', there are two different methods for performing manual muscle testing.

1. Break testing in manual muscle testing, is when resistance is applied to the body part at the end of the available range of motion. It's called the break test because when a therapist provides resistance the objective for the patient is to not allow the therapist to "break" the muscle hold.

2. Active Resistance testing in manual muscle testing is when resistance is applied through the body part through the available range of motion. This type of manual muscle testing requires skill and experience and is not the recommended practice.

Muscle Testing is a fundamental skill that every physiotherapist must attain since it is required to diagnose and assess any potential movement impairment. Manual muscle testing is a method that is commonly used in order to evaluate and determine the strength of a muscle or muscle group. This is an essential component of a functional movement pattern.

Using muscle assessment tools provides information for the physiotherapist pertaining to a patient’s body region being weak or normal. This could be essential especially when the physiotherapist is introducing gait training with an assisted device or designing a rehabilitation program post-surgery. It provides necessary information with regards to the patient’s ability to maximally contract a muscle. Using muscle assessment, a therapist can determine if the patient has enough strength to sustain weight through the lower extremities and upper extremities. Moreover, muscle strength impairments can also identify certain mobility limitations. This indicator can help predict certain outcomes such as hospital length stay of a patient post-surgery.

Manual Muscle Testing is a technique used by a physiotherapist to examine the strength of a muscle/muscle group. MMT emphasizes the use of observation, palpation, and the resistance applied by the examiner to evaluate and determine muscle strength. It requires no equipment which makes it a versatile tool for a physiotherapist. The effects of gravity are taken into consideration in this type of testing. Adequate stabilization is emphasized throughout every test allowing a physiotherapist to evaluate the overall output of the muscle/muscle group.

However, the grade given to a muscle/muscle group consists of subjective and objective factors. Subjective factors include the therapist’s opinion of the amount of resistance to apply prior to the test and the actual amount of resistance the patient can tolerate. Objective factors include the patient’s ability to successfully complete a full range of motion, the ability to hold a position throughout the test or to be able to move the tested part against gravity. These factors require immense experience and skills in order to formulate a meticulous and precise clinical judgment. Therefore, the subjectivity of the patient’s resistance and differences in their muscle strength can contribute as a limitation. This can sometimes undermine the reliability of MMT.

All things considered, muscle strength testing is commonly tested as a part of physical examination. MMT is extensively used since it requires no equipment however is influenced by the therapist's judgment and resistance. It appears to be a reliable and valid testing tool in the presence of extreme weakness such as observed in neuromuscular diseases. However, MMT should be considered as a screening tool amongst individuals with almost normal muscle strength levels. Nevertheless, through considerable practice and experience, an accurate test grading can be achieved which would allow a therapist to establish a functional diagnosis and also assist in examining and monitoring a patient’s progress.