MMT Grades | Principles and Grades
-
Dr.
Arpita Biswas
- Dr.Rahul Kr. Jha
- Disclaimer
Table of Contents
The MMT Grading system
MMT(manual muscle test) are recorded as numerical scores ranging from zero (0), which represents no activity, to five (5), which represents a “normal” or best-possible response to the test or as great response as can be evaluated by a manual muscle test.
The following points are applicable to nearly every case requiring muscle [testing] and are of utmost importance for successful work:
1. Determine justΒ what muscles are involved by carefulΒ testing and charting the degree of power in each muscle or group to be treated.
2. Insist on suchΒ privacy and disciplineΒ as will gainΒ patient’s cooperationΒ and undivided attention. . . .
3. Use some method ofΒ preliminary warming up of theΒ musclesΒ . . . doubly essential in the cold, cyanotic and weakened muscles. . . .
4. Have the entire part free from covering and so supported as not to bring strain . . .Β from gravity . . .Β or antagonists.
Grade 5 (Normal) Muscle
The ability to complete aΒ full range of motionΒ or maintain end-point range against maximal resistance.
Grade 4 (Good) Muscle
Mmt Grade 4 is used to designate a muscle group that is able to complete aΒ full range of motion againstΒ gravityΒ and can tolerate strong resistance without breaking the test position. The Grade 4 muscle ‘gives ” or “yields” to some extent at the end of it range withΒ maximal resistance.
Grade 3 (Fair) Muscle
The muscle or muscle group can completeΒ a full range of motion against only the resistance ofΒ gravity.Β If a tested muscle can move through the full range against gravity but additional resistance, however mild, causes the motion to break, the muscle is assigned aΒ mmtΒ gradeΒ of 3 (Fair).
Grade 2 (Poor) Muscle
TheΒ mmt GradeΒ 2 (Poor) muscle is one thatΒ can completeΒ the full range of motion in a position that minimizesΒ the force of gravity. This positionΒ isΒ oftenΒ described as the horizontal plane of motion.
Grade 1 (Trace) Muscle
TheΒ mmt GradeΒ 1 (Trace) muscle means that the examinerΒ can detect visually or by palpation some contractileΒ activity in one or more of the musclesΒ that participate in the movement being tested (provided that the muscle is superficial enough to be palpated). The examiner also may be able to see or feel a tendon pop up or tense as patient tries to perform the movement.
Grade 0 (Zero) Muscle
The Grade 0 (Zero) muscle is completely quiescent on palpation or visual inspection.
Plus (+) and Minus (-) Grades
Use of a plus (+) or minus (-) addition to a manual muscle test grade is discouraged except in three instances: Fair+, Poor+, and Poor-.
Grade 3+ (Fair+) Muscle
The Grade 3+ muscle can complete a full range of motion against gravity, and the patient can hold the end position against mild resistance.
For example, a patient with weak wrist extensors at Grade 3 cannot use a wrist-hand orthosis (WHO ) effectively, but a patient with a Grade 3+ muscle can use such a device. Likewise, patient with only Grade 3 ankle dorsiflexion cannot use a shoe-insert type of ankle-foot orthosis functionally. The patient with Grade 3+ dorsiflexion can tolerate the added weight of the brace, which is comparable to the mild resistance used in the test.
Β
Grade 2+ (Poor+) Muscle
The 2+ Grade is clearly distinguished from Grade 2, which indicates that the full range is completed with no resistance.
Grade 2 – (Poor- ) Muscle
The Grade 2- (Poor-) muscle can complete a partial range of motion in the horizontal plane, the gravity-minimized position.
For example, a patient with infectious neuronitis (Landry-Guillain-Barre syndrome) who moves from muscle Grade 1 to Grade 2– demonstrates a quantum leap forward in terms of recovery and prognosis.
What is the available Range of Motion?
When any condition limits the joint range of motion, the patient can perform only within the range available.
In this circumstance, the available range is the full range of motion (ROM) for that patient at that time, even though it is not “normal.” This is the range used to assign a muscle testing grade. For example, the normal knee extension range is 135 Β° to 0Β° . A patient with a 20 Β° knee flexion contracture is tested for knee extension strength.
This patient’s maximal range into extension is -20Β°. If this range (in sitting) can be completed with maximal resistance, the grade assigned would be a 5 (Normal). If patient cannot complete that range, the grade assigned MUST be less than 3 (Fair). The patient then should be repositioned in the side-lying position to ascertain the correct grade.
SUBSCRIBE
subscribe to our newsletter and stay updated
Difference between neuropathy and polyneuropathy
Difference Between neuropathy and polyneuropathy ? What is Neuropathy (Mononeuropathy)? Neuropathy is neurological condition in which their is damage to.......
Walking Aids
Walking Aid Table of Contents What is a Walking Aid? There are a number of Walking Aids available to assist.......
LEPROSY
Leprosy Table of Contents Introduction Leprosy or Hasen’s disease is a chronic nonfatal infectious disease, which is caused by mycobacterium.......
Nutrition in cancer
Nutrition in cancer Table of Contents Best diet for cancer patients Cancer is characterized by abnormal cell growth. It can.......
Stroke Recovery and Rehabilitation
Stroke and Rehabilitation Table of Contents Stroke and Rehabilitation has an important role in increasing participation in societal roles by.......
knee joint
Knee joint Table of Contents The knee is largest and most complex joint of the body. The complexity is the.......