Manual muscle testing is used to measure variations of muscle weakness that results from a disease, disuse or injury. Assessment and data recording obtained provides a measuring tool for planning therapeutic care. Periodic retesting throughout rehabilitation provides a means of recording progress or setbacks from the initial baseline test. Testing for strength is recorded as trace or zero, poor, fair, normal and good. MMT was developed in 1917 by Dr. Robert Lovett, an orthopedic surgeon at Harvard Medical School.
Performing a Manual Muscle Test
According to the American Academy of Orthopaedic Surgeons, testing for strength of muscles occurs as follows: a physician will ask you to move in certain ways while she applies a resistive force. For example, the physician will ask you to sit in a chair and then attempt to raise one knee while pressing down on your upper leg. Or, the physician will hold your elbow at a 90-degree angle and ask you to bend your wrist down.
Manual Muscle Testing Children
Obtaining accurate documentation and testing children can be difficult if the health care provider is not able to convey to you what needs to happen. The National Institute of Environmental Health Sciences has developed a MMT dialogue to improve testing outcomes. The following is a useful scenario. "I'm going to see how strong you are. When I tell you hold and don't let me push you, you try really, really hard not to let me move you. You need to be strong like a tree or a Power Ranger."
Proper Technique
Good technique is important so that the test results are valid and can also be reproduced again or by other health care providers. This is referred to as inter-tester or intra-tester reliability. In a 2007 study titled "On the Reliability and Validity of Manual Muscle Testing: A Literature Review," some important factors are needed for proper technique: proper positioning, adequate stabilization, having the patient maintain the test position, consistent timing and pressure, and nonpainful contacts during testing.
Precautions
Some precautions for manual muscle testing involve the presence of an inflammatory process or infection in the involved muscles and joints. Painful conditions that might interfere and increase your symptoms should also be monitored. Excessive fatigue can affect the quality of a test and results. If you have cerebral palsy, altered muscle reflex activity or other muscle spastic conditions, it will cause difficulty during MMT. Objective documentation throughout your treatment is important to measure progress but should not interfere with your care.
Considerations
Manual muscle testing requires patience, gentleness and skills to obtain effective testing and outcomes. MMT always involves testing the affected muscle or muscle group against the unaffected side to create a comparison. MMT also has a numerical scale for ease of documentation. This ranges from 1 = poor to 5 = normal. A test might be written as 3+/5 or 2-/5 with a plus or minus allowing for a grade within the range for added precision.
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