Intro to Muscle Performance (9/4c) Flashcards Preview

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1

Muscle strength

“the maximal force a muscle or muscle group can generate at a specified or determined velocity”

2

How we can test muscle activity

Electromyography (EMG)

3

Strength testing

Used in all parts of Patient Management Model***

Examining their movement, determining diagnosis, in interventions, determining prognosis, and proving outcomes

4

Isotonic contraction (strength testing)

force generated by a muscle while contracting, comprised of concentric and eccentric movements

1 Rep Max = Determine how much weight they can do full ROM for one rep
EX: quads - knee extension machine

5

Isokinetic contraction (strength testing)

dynamic contraction but movement speed is controlled by machine

Dynamometer
EX: quads - test at 60 deg/sec, 90 deg/sec, etc

6

Isometric contraction (strength testing)

muscle contraction without the muscle or joints moving; static tension

EX: Manual Muscle Testing, dynamometer, HHD

7

Manual Muscle Testing (MMT)

A system of measurement using manually applied resistance to determine the strength of a muscle

Gravity based system, quantifies muscle strength, reliability adequate

8

Ordinal Measurement Scale for MMT

6 point scale

0 = no muscle contraction
5 = movement through complete ROM against gravity and maximal resistance

Numbers mean the exact same thing as words

9

Grades for MMT - Good/Normal

Normal (N or 5): Able to move through the FULL available range of motion, against gravity, and able to hold against MAX manual resistance

Good (G or 4): Able to move through FULL available range of motion, against gravity and able to hold against MODERATE manual resistance

10

Grades for MMT - Fairs (+/-)

Fair + (F+ or 3+): Able to move through FULL available range of motion against gravity and able to hold against MINIMAL manual resistance

Fair (F or 3): Able to move through the FULL available range of motion, against gravity with NO manual resistance (*FAIR TEST*)

Fair – (F- or 3-): Able to move through OVER HALF the available range of motion against gravity and NO manual resistance

11

Grades for MMT - Poors (+/-)

Poor + (P+ or 2+): Able to move through UNDER HALF the available range of motion against gravity and NO manual resistance

Poor (P or 2): Able to move through the FULL available range of motion in a GRAVITY MINIMIZED position

Poor – (P- or 2-): Able to move through PARTIAL range of motion in a GRAVITY MINIMIZED position and NO manual resistance

12

Grades for MMT - Trace/Zero

Trace (T or 1): NO joint motion, GRAVITY MINIMIZED position, muscle contraction IS palpable or observable

Zero (0): NO observable or palpable muscle contraction

13

Subjective part of MMT

amount of resistance pt tolerates during test

Validity above 3/Fair is much less than below 3

14

Objective part of MMT

ability of pt to complete full ROM or hold position once placed there

ability to move part against gravity or inability to move at all

15

Steps of MMT

1) explain purpose to pt

2) position patient and expose part

3) begin with fair test

4) compare to uninvolved side

5) test muscles using manual resistance if above fair/3 (via break test, make test, or resistance through ROM)

16

Break test (MMT)

“Hold this position, don’t let me move you”

PT applies resistance until muscle contraction overcome by PT

Most commonly used in MMT

More force produced than the “make” test

17

Make test (MMT)

“Push into me, start slowly and gradually increase”

Set force level (usually @ fixed position), ask patient to match it

Used for MVIC testing

Force lower than break test

Commonly used with HHD (not typically used with MMT)

18

Resistance through ROM (MMT)

have patient do full ROM, PT push against

19

Things to consider when assessing "normal" (MMT)

Size, age, gender

Symmetry, experience

Substitution, pain, motivation, ability, decreased ROM

20

Body parts with special grades (MMT)

Finger/toes
Facial muscles
Trunk
Weight-bearing muscles

21

MMT validity

Grades above Good (4) - not strong relationships with other strength measures

Grades below Good (4) - strong relationships with other strength measures

22

MMT reliability

Variable depending on: muscle tested; experience/education of tester; patient’s motivation/understanding/fatigue

Need to use standardized methods

23

Pros/Cons of MMT

PROS: Always available, Inexpensive, Useful for individual muscles

CONS: Imprecise, Reliability/validity issues; ceiling effects