MMT Basics and Principles 3 — Questions and Answers
Question 1: Which condition must be met before assigning an MMT grade of '5' (Normal)?
- Muscle completes full ROM in gravity-eliminated position
- Muscle holds end-range position against maximum resistance (Correct answer)
- Muscle completes full ROM against gravity only
- Muscle shows visible contraction without movement
Correct answer: Muscle holds end-range position against maximum resistance
Grade 5 (Normal) requires the muscle to hold the test position against maximum examiner resistance without giving way.
Question 2: When a patient substitutes with the tensor fasciae latae during hip abduction testing, which grade modification is appropriate?
- Upgrade by one grade
- Record the achieved grade with a note of substitution (Correct answer)
- Assign grade 0
- Repeat the test without modification
Correct answer: Record the achieved grade with a note of substitution
When substitution occurs, the examiner documents the actual grade achieved but notes the compensatory muscle activity to avoid overestimating target muscle strength.
Question 3: In MMT grading, the '+' and '-' modifiers (e.g., 3+, 4-) indicate what?
- Patient cooperation level
- Strength within the grade range but closer to the boundary (Correct answer)
- Degree of pain during testing
- Range of motion completeness
Correct answer: Strength within the grade range but closer to the boundary
Plus and minus modifiers indicate that strength falls within a grade but is closer to the upper (+) or lower (-) boundary of that grade.
Question 4: Which factor does NOT directly influence the resistance applied during MMT?
- Limb length
- Patient age
- Patient skin condition (Correct answer)
- Body weight of the limb segment
Correct answer: Patient skin condition
Skin condition does not affect the force required to move or hold a limb segment; limb length, age, and segment weight all influence expected resistance levels.
Question 5: The Medical Research Council (MRC) scale and Kendall MMT scale both use 0-5 grading; what is a key difference?
- MRC uses gravity-eliminated positions for all grades
- Kendall uses plus/minus modifiers; MRC traditionally does not (Correct answer)
- MRC tests isometric strength only
- Kendall grades are based on EMG findings
Correct answer: Kendall uses plus/minus modifiers; MRC traditionally does not
The Kendall system commonly employs plus/minus modifiers to refine grades, while the traditional MRC scale uses whole numbers without modifiers.
Question 6: Why should MMT not be performed immediately after fatiguing exercise?
- It increases risk of joint dislocation
- Fatigue artificially lowers muscle grade (Correct answer)
- It causes inaccurate ROM measurements
- Resistance cannot be properly calibrated
Correct answer: Fatigue artificially lowers muscle grade
Post-exercise fatigue reduces a muscle's ability to generate force, causing it to appear weaker than its true baseline strength.
Question 7: In pediatric MMT, which modification is most commonly required compared to adult testing?
- Using heavier resistance
- Adjusting instructions and using play-based cooperation strategies (Correct answer)
- Testing only in gravity-eliminated positions
- Skipping stabilization
Correct answer: Adjusting instructions and using play-based cooperation strategies
Children may not follow standard verbal instructions reliably, so examiners use age-appropriate language and play-based tasks to elicit cooperative effort.
MMT Basics and Principles 3
Which condition must be met before assigning an MMT grade of '5' (Normal)?