Force exerted by a muscle or group of muscles to overcome resistance in one max effort
Strength
Work/time
Power
Ability of a muscle to contract repeatedly over time
Endurance
A muscle or muscle group that makes major contributions to movement at a joint
Agonist or prime mover
A muscle that contracts and works along with the agonist to produced desired movement
Synergist
3 types of synergists
- Neutralizing or counteracting
- Conjoint
- Stabilizing or fixating
Muscles that contract to prevent unwanted movements produced by prime mover
Neutralizing or counteracting synergist
2 or more muscles that work together to produce desired movement
Conjoint synergist
Muscles that prevent movement or control movement at joints proximal to moving joint to provide a stable base
Stabilizing or fixating synergist
6 precautions for MMT
- Extreme pain/edema
- Extreme weakness
- MD says no
- Cardiac conditions
- Osteoporosis
- Limitations in cog/emotional status
6 probable contraindications for MMT
- Unhealed fracture
- Serious tear
- Neoplasm
- Pain of unknown etiology
- Thrombophlebitis
- Inflammation
New abnormal growth of tissue
Neoplasm
Inflammation in walls of a vein
Thrombophlebitis
Always have pt perform ______ before MMT
AROM
If pt cant perform full AROM….
Reposition in gravity-eliminated position
Where do you apply resistance for a break test?
Near distal end of segment to which muscle attaches
Difference between break test and active resistive testing
Break test: isometric
Active resistive: resistance against direction of movement thru ROM
When would active resistance/dynamic testing be a good MMT for a pt?
Unstable angina, acute MI
Which MMT is better for assessing endurance?
Active resistive/dynamic testing
More objective MMT
Break test
2 things that are difficult to assess in break test
- Functional strength
2. Fatigue
Describe the MMT grade: 5
Cannot break the hold against max resistance
Describe the MMT grade: 4
Can tolerate strong resistance; muscle gives with max resistance
Describe the MMT grade: 3+
Holds end position against resistance
Describe the MMT grade: 3
Completes full ROM against gravity
Describe the MMT grade: 3-
Does not complete ROM but greater than 1/2 range
Describe the MMT grade: 2+
Initiates movement against gravity OR in gravity minimized position w slight resistance
Describe the MMT grade: 2
Completes full ROM in gravity eliminated position
Describe the MMT grade: 2-
Completes partial ROM in gravity eliminated position
Describe the MMT grade: 1
Examiner can detect contractile activity, but no movement
Describe the MMT grade: 0
Muscle is completely quiet
4 ways to improve reliability of MMT
- Standardize position
- Stabilization of proximal body parts
- Using grading criteria
- Intrarater
6 things that cause variance in measurement of hand-held dynamometry
- Method of applying resistance
- Body position in relation to gravity
- Joint angle
- Lever arm
- Stabilization
- Examiner’s strength
Isokinetic dynamometry can measure….
Torque, work, endurance
When finding muscle weakness, assess _____________
Muscle length
2 types of muscle weakness + define
- Stretch weakness: muscles remain in an elongated position (postural)
- Over-stretch weakness: from multi-joint muscles; from repetitive or habitual stretching that elongate