MMT Special Considerations 2 — Questions and Answers
Question 1: When testing a patient with severe osteoporosis, which modification is most appropriate during MMT?
- Apply force proximal to the joint to reduce lever arm
- Avoid all resistance and use gravity-eliminated positions only
- Use a shorter lever arm by placing resistance closer to the joint (Correct answer)
- Increase test repetitions to compensate for reduced force application
Correct answer: Use a shorter lever arm by placing resistance closer to the joint
Placing resistance closer to the joint shortens the lever arm, reducing torque and minimizing fracture risk in osteoporotic bones.
Question 2: A patient with acute DVT in the lower extremity requires MMT. Which is the safest approach?
- Test only distal muscles below the clot
- Postpone lower extremity MMT until DVT is resolved or cleared by physician (Correct answer)
- Use isometric testing only with minimal pressure
- Perform MMT in a gravity-eliminated position to avoid venous compression
Correct answer: Postpone lower extremity MMT until DVT is resolved or cleared by physician
Active lower extremity MMT with a DVT risks dislodging the thrombus, so testing should be deferred until medically cleared.
Question 3: Which condition most significantly invalidates standard MMT grades due to velocity-dependent resistance?
- Peripheral neuropathy
- Spasticity (Correct answer)
- Muscle atrophy
- Joint contracture
Correct answer: Spasticity
Spasticity produces velocity-dependent resistance that artificially inflates perceived muscle strength, making standard MMT grades unreliable.
Question 4: When performing MMT on a patient who is 32 weeks pregnant, which position should generally be avoided?
- Seated
- Side-lying
- Supine (Correct answer)
- Prone
Correct answer: Supine
Supine positioning after 20 weeks of pregnancy risks supine hypotensive syndrome due to vena cava compression by the uterus.
Question 5: A patient with a grade 2/5 MMT score for hip flexion most likely demonstrates which functional ability?
- Can lift the leg against gravity with full ROM
- Can flex the hip against gravity only through partial ROM
- Can move the hip through full ROM only in a gravity-eliminated position (Correct answer)
- Cannot produce any palpable muscle contraction
Correct answer: Can move the hip through full ROM only in a gravity-eliminated position
Grade 2 indicates active movement through full ROM only when gravity is eliminated, such as in side-lying.
Question 6: Which factor most compromises the reliability of MMT when comparing results between two different examiners?
- Patient age
- Examiner hand placement and applied force variation (Correct answer)
- Time of day testing is performed
- Patient's level of fatigue
Correct answer: Examiner hand placement and applied force variation
Inter-rater reliability in MMT is most affected by inconsistent stabilization, hand placement, and the subjective amount of force each examiner applies.
Question 7: When documenting MMT for a patient with pain that limits full effort, the clinician should:
- Record the grade as if full effort were given
- Lower the grade by one point to account for pain inhibition
- Record the observed grade and note pain as a limiting factor (Correct answer)
- Defer scoring until the patient is pain-free
Correct answer: Record the observed grade and note pain as a limiting factor
Accurate documentation requires recording the actual observed performance while noting that pain limited full effort, preserving clinical validity.
MMT Special Considerations 2
When testing a patient with severe osteoporosis, which modification is most appropriate during MMT?