MMT Testing Procedures 2 — Questions and Answers
Question 1: When testing a muscle against gravity, the patient is placed so that the body segment moves through its range in which plane?
- Horizontal
- Diagonal
- Vertical (Correct answer)
- Oblique
Correct answer: Vertical
Against-gravity testing positions the segment so movement occurs in a vertical plane, requiring the muscle to work against the full effect of gravity.
Question 2: Which MMT grade is assigned when a patient can move a body segment through full ROM in a gravity-eliminated position but cannot hold against any manual resistance?
- Grade 1
- Grade 2 (Correct answer)
- Grade 3
- Grade 4
Correct answer: Grade 2
Grade 2 (Poor) indicates full ROM is achieved only when gravity is eliminated and no additional resistance is overcome.
Question 3: During manual muscle testing, a 'break test' is best described as:
- Moving the limb through full ROM against resistance
- Applying resistance at end range until movement is broken (Correct answer)
- Testing muscle strength in a shortened position only
- Measuring resistance at the midpoint of ROM
Correct answer: Applying resistance at end range until movement is broken
A break test involves placing the segment at end range and applying force until the patient can no longer hold the position, allowing assessment of isometric strength.
Question 4: For which MMT grade does the examiner apply minimal resistance throughout the full range of motion?
- Grade 2+
- Grade 3+
- Grade 4 (Correct answer)
- Grade 5
Correct answer: Grade 4
Grade 4 (Good) is defined as the ability to complete full ROM against gravity and tolerate moderate resistance, but minimal resistance applied throughout still falls within the Grade 4 range description.
Question 5: What is the PRIMARY reason the examiner must stabilize the proximal segment during MMT?
- To increase patient comfort
- To prevent substitution by adjacent muscles (Correct answer)
- To ensure the distal segment moves freely
- To reduce patient fatigue
Correct answer: To prevent substitution by adjacent muscles
Proximal stabilization prevents compensatory movements and substitution patterns that would give a falsely elevated muscle grade.
Question 6: When documenting MMT, a grade of '3+' means the muscle:
- Completes partial ROM against gravity
- Completes full ROM against gravity and holds against minimal resistance (Correct answer)
- Completes full ROM gravity-eliminated with trace activity
- Tolerates moderate resistance through full ROM
Correct answer: Completes full ROM against gravity and holds against minimal resistance
A plus modifier on Grade 3 indicates the muscle completes full against-gravity ROM and can tolerate some minimal resistance before giving way.
Question 7: Which of the following conditions would MOST warrant using a gravity-eliminated test position even for a patient suspected of having Grade 3 strength?
- Patient reports mild fatigue
- Examiner is unsure of normal resistance level
- Patient has significant pain limiting full effort
- Patient's limb is very long and heavy (Correct answer)
Correct answer: Patient's limb is very long and heavy
An exceptionally heavy limb can effectively increase the load beyond standard gravity conditions, so gravity-eliminated testing may provide a more accurate baseline assessment.
MMT Testing Procedures 2
When testing a muscle against gravity, the patient is placed so that the body segment moves through its range in which plane?