MMT (Manual Muscle Testing) Of Shoulder Flexion , Grades

Manual Muscle Testing Of Shoulder Flexion

The Manual Muscle Test for Shoulder flexion to evaluate the Anterior Deltoid and Coracobrachialis muscles.

Table of content 1- Manual Muscle Testing Of sholder flexion 2- Which Muscles Involved 3- Grading

Shoulder flexion Muscles Involved:

• Anterior Deltoid

• Coracobrachialis

Grade 5 (Normal), Grade 4 (Good)

Position of Patient:

Short sitting with arms at sides, elbow slightly flexed, forearm pronated.

Position of Therapist:

Stand at test side. Hand giving resistance is contoured over the distal humerus just above the elbow. The other hand may stabilize the shoulder

Test:

Patient flexes shoulder to 90 ° without rotation or horizontal movement . The scapula should be allowed to abduct and upwardly rotate.

Instructions to Patient:

"Raise your arm forward to shoulder height. Hold it. Don't let me push it down."

Grading :

Grade 5 (Normal):

Holds end position (90° ) against maximal resistance.

Grade 4 (Good)::

Holds end position against strong to moderate resistance.

Grade 3 (Fair):

Completes available range and holds the position without resistance .

Position of Patient:

Short sitting, arm at side with elbow slightly flexed and forearm pronated.

Position of Therapist:

Stand at test side.

Test:

Patient flexes shoulder to 90 °.

Instructions to Patient:

"Raise your arm forward to shoulder height"

Grade 2 (Poor) , Grade 1 (Trace), and Grade 0 (Zero):

Position of Patient:

Short sitting with arm at side and elbow slightly flexed.

Position of Therapist:

Stand at test side. Fingers used for palpation are placed over the superior and anterior surfaces of the deltoid over the shoulder joint

Test:

Patient attempts to flex shoulder to 90° .

Instructions to Patient:

"Try to raise your arm."

Grade 2 (poor), Grade 1 (Trace) and Grade 0 (Zero):

Grading:

Grade 2 (poor):

Completes partial range of motion as this is against gravity

Grade 1 (Trace):

Examiner feels or sees contractile activity in the anterior deltoid, but no motion occurs.

Grade 0 (Zero): :

No palpable contractile activity.

In short *The coracobrachialis muscle cannot be isolated, nor is it readily palpable. It has no unique function. It is included here because classically it is considered a shoulder flexor and adductor.

Alternate Test for Grades 2, 1, and 0 :

If for any reason the patient is unable to sit, the test can be conducted in the side-lying position (test side up). In this posture, the examiner cradles the test arm at the elbow before asking the patient to flex the shoulder. For Grade 2 (Poor), the patient must complete full range of motion.