Upper Extremity Manual Muscle Testing

Tests individual muscles and muscle groups (motions)

Looks at Joint AROM (Complete, Partial, None?)
Looks at amount of Resistance (Maximal, Moderate, Slight?)
Can do MMT against gravity or on a gravity eliminated plane
depending on ct.
Always look at AROM before assessing STRENGTH!

MMT Grades
Numb Word/Lett
er
er
0

2-

2+

3-

Zero (0)

Definition

No muscle
contraction seen or
felt
Trace(T)
Muscle contraction
observed or felt, but
no movement
Poor minus Part moves through
(P-)
incomplete AROM
gravity eliminated
Poor (P)
Part moved through
complete AROM
gravity eliminated
Poor Plus
Part moves through
(P+)
<50% AROM against
gravity OR complete
AROM gravity
eliminated against
slight resistance
Fair minus
Part moves >50%
(F-)
AROM against
gravity
Fair (F)
Part moves complete

Resistance
(Y/N)
N

AROM against
gravity
3+
Fair Plus
Part moves through
Y
(F+)
full AROM against
gravity w/slight
resistance
4
Good (G)
Part moves through
Y
full AROM against
gravity with
moderate resistance
5
Normal (N) Part moves through
Y
full AROM against
gravity with maximal
resistance
***Zero is flaccid, no tone
***Zero, Trace & Poor Grades are in gravity eliminated plane
***Fair, Good & Normal Grades are against gravity
***Gravity eliminated means on a horizontal plane

When Administering the Break Test (MMT)

1. Ask Client - Can you move your arm up toward the ceiling like this?
(Observe how they do)
2. Then say - Okay, please do the same movement again. Now, position
arm full ROM. (STABILIZE PROXIMALLY & PALPATE)
3. Then say Good, now, hold your arm in this position & dont let me
push it down, up, in or out depending on what muscle or muscle group
you are testing.
4. Apply resistance distally In direction movement came from (LIGHT
AT FIRST & INCREASE TO MAX OVER 2-3 SECONDS)

MMT table: Assuming all AROM is WNL AG

Movemen
t

ROM
Norm

Optimal
client
position

Therapist
stabilizes

Resistanc
e applied
@

Shld
flexion
Shld
extension
Shld abd

0-180

seated

shoulder

0-60

prone

shoulder

0-180

seated

Shld ER

0-90

Shld ER
(GE)
Shld IR

0-80

Distal
humerus
Distal
humerus

distal
forearm
distal
forearm

Shld IR
(GE)
Elbow flex

0-60
0-135

Prone
(shld abd
90, elbow
flexes 90)
gunslinge
r
Prone;
Prone
(shld abd
90, flex
elbow 90)
gunslinge
r
Seated
(anatomic
al
position)

Shld/scapu
la
Distal
humerus

Distal
humerus
Distal
humerus
Distal
humerus
distal
forearm

distal
forearm
distal
forearm
(palpate
biceps)

Elbow ext

135-0

Distal
humerus
Distal
(over
muscle
belly)
humerus
Distal
humerus

supinatio
n

0-80/90

Distal
humerus

distal
forearm

pronation

0-80/90

Distal
humerus

distal
forearm

0-70

Prone;
shld abd
90, elbow
flex 90.
Forearm
neutral)
Seated;
gunslinge
r
Seated;
gunslinge

distal
forearm
(palpate
triceps)

Wrist flex

0-90

Wrist /

0-80

r
Seated,
forearm
resting on
table in
mid
position
OR full
supinatio
n
Seated,
forearm
resting on
table OR
pronated

distal
forearm

Palm on
radial
side

distal
forearm

Palm over
2nd & 3rd
MCP

Things to remember:
Always explain to client what you are going to do
Stay off of clients joints
Stabilize proximally, Palpate muscle group & Apply resistance distally