MMT Clinical Applications 4

Question 1

A patient demonstrates fasciculations and progressive atrophy in tested muscles alongside MMT grades of 2-3. These findings are most consistent with:

Accepted Answer

Lower motor neuron lesion

Answer

Upper motor neuron lesion

Answer

Myopathy

Answer

Psychogenic weakness

Question 2

When testing the quadriceps in a patient who has recently undergone ACL reconstruction, which precaution is most relevant?

Accepted Answer

Avoid terminal knee extension resistance in the early healing phase

Answer

Test only in the closed-chain position to protect the graft

Answer

Apply resistance at the hip rather than the ankle

Answer

Avoid testing until 6 weeks post-surgery

Question 3

A therapist is performing MMT on a patient with polymyositis. Which pattern of weakness would be most characteristic?

Accepted Answer

Symmetric proximal extremity weakness

Answer

Distal extremity weakness greater than proximal

Answer

Asymmetric upper extremity weakness only

Answer

Weakness primarily in the facial muscles

Question 4

During MMT documentation for a legal or disability evaluation, which practice best ensures reliability and defensibility of grades?

Accepted Answer

Documenting the exact test position, stabilization, and direction of resistance applied

Answer

Using whole-number grades only without plus/minus modifiers

Answer

Averaging grades from two separate testers

Answer

Testing only in weight-bearing functional positions

Question 5

A patient with multiple sclerosis is being tested on a warm day and shows notably lower MMT grades than on a previous cool day. This phenomenon is best explained by:

Accepted Answer

Uhthoff's phenomenon — heat-sensitive conduction block in demyelinated axons

Answer

Decreased motivation due to fatigue

Answer

Spasticity increase from ambient heat

Answer

True disease progression since last test

Question 6

Which compensatory strategy most commonly invalidates MMT of the hip extensors (gluteus maximus) during prone testing?

Accepted Answer

Hamstring substitution for hip extension

Answer

Pelvic anterior tilt substituted by lumbar paraspinals

Answer

Contralateral hip hike by quadratus lumborum

Answer

Knee flexion to reduce hamstring contribution

Question 7

A patient with carpal tunnel syndrome undergoes MMT. Which specific muscle is most critical to test to determine severity of median nerve compression?

Accepted Answer

Abductor pollicis brevis

Answer

Flexor digitorum superficialis

Answer

Flexor carpi radialis

Answer

Lumbricals of the index and middle fingers