MMT Grading Systems 3 — Questions and Answers
Question 1: What distinguishes Grade 4 from Grade 5 in the MRC MMT scale?
- Presence of pain
- Ability to complete full ROM
- Ability to resist some but not full examiner resistance (Correct answer)
- Use of gravity elimination
Correct answer: Ability to resist some but not full examiner resistance
Grade 4 muscles move through full ROM against gravity and some resistance, but can be overcome by the examiner.
Question 2: In the modified MMT system with plus/minus grades, how many total gradations exist between 0 and 5?
- 6
- 10
- 13 (Correct answer)
- 16
Correct answer: 13
Including the +/− modifiers, the scale expands to 13 gradations (0, 1−, 1, 1+, 2−, 2, 2+, 3−, 3, 3+, 4−, 4, 4+, 5).
Question 3: When grading is done in a gravity-eliminated position for shoulder abduction, which plane is typically used?
- Sagittal plane
- Frontal plane
- Horizontal (transverse) plane (Correct answer)
- Diagonal plane
Correct answer: Horizontal (transverse) plane
Gravity-eliminated testing for shoulder abduction is performed with the patient side-lying so movement occurs horizontally.
Question 4: A Grade 3− finding indicates the muscle:
- Moves through less than half the range against gravity (Correct answer)
- Moves through more than half the range against gravity
- Completes full range against gravity with minimal resistance
- Fails to move against gravity at all
Correct answer: Moves through less than half the range against gravity
Grade 3− means the muscle moves through less than half of the ROM against gravity without added resistance.
Question 5: Which grading system uses a 0–10 numerical scale rather than 0–5?
- MRC scale
- Lovett scale
- Kendall percentage scale converted to 0–10 (Correct answer)
- Daniels & Worthingham scale
Correct answer: Kendall percentage scale converted to 0–10
Kendall's system uses percentages (0–100%) which are sometimes represented as a 0–10 scale for clinical shorthand.
Question 6: For a Grade 2+ score, what must the patient demonstrate?
- Full ROM in gravity-eliminated position with some resistance
- Partial ROM against gravity (Correct answer)
- Full ROM against gravity
- Visible contraction only
Correct answer: Partial ROM against gravity
Grade 2+ indicates the patient completes full gravity-eliminated ROM and moves partially (less than half) against gravity.
Question 7: The primary reason MMT grades above 3 require the examiner to apply resistance is to:
- Standardize patient positioning
- Differentiate between normal and slightly reduced strength (Correct answer)
- Assess pain response
- Evaluate endurance
Correct answer: Differentiate between normal and slightly reduced strength
Resistance allows the examiner to distinguish Grade 4 (some resistance) from Grade 5 (full resistance) strengths.
MMT Grading Systems 3
What distinguishes Grade 4 from Grade 5 in the MRC MMT scale?