UE Manual Muscle Testing

Terms to Know:

• Strength: “the ability to demonstrate a degree of power of a muscle when movement is resisted, as with objects or gravity”

• Manual Muscle Test (MMT): testing individual muscles and muscle groups

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How to Administer Break Test:

1. Perform ROM first

2. Explain procedure to client [“I’d like to take a look at how strong your arms are. I’m going to ask you to move your arm in different directions and then, I will ask you to hold it as tight as you can while I give you some resistance. If you have any discomfort during the process, please be sure to let me know and we will stop.”]

3. Demonstrate each movement

4. Position limb to be tested against gravity (if client cannot move against gravity, you will need to assess in gravity eliminated position)

5. Have client move through full AROM

6. Have client repeat movement

7. Apply resistance to the distal end of the segment into which the muscle inserts and in the direction the movement came from (starting position is usually at client's 50% ROM)

8. Initially light resistance and increase to maximal resistance over 2-3 seconds

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Grading Scale:

Against Gravity:

Normal (N) --> 5/5 = Maximum Resistance

Good (G) --> 4/5 = Moderate Resistance

 Good Minus (G-) --> 4-/5 = Less than Moderate, more than Minimal

Fair Plus (F+) --> 3+/5

 Fair (F) --> 3/5 = No Resistance

  Fair Minus (F-) --> 3-/5 = < full ROM, but > 50%

 Poor Plus (P+) --> 2+/5

Gravity Eliminated:

Poor (P) --> 2/5

Poor Minus (P-) --> 2-/5

Trace (T) --> 1/5

Zero (0) --> 0/5 

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Hand Placements for Break Tests:

Movement MMT Hands Placement

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Shoulder Flexion -Hand over shoulder joint

-Hand at distal humerus

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Shoulder Extension -Hand over shoulder joint

-Hand at distal humerus along triceps

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Shoulder Abduction -Hand over shoulder joint

-Hand at distal humerus before elbow joint

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Shoulder External Rotation -Hold elbow joint

-Hand at distal wrist (outside of wrist)

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Shoulder Internal Rotation -Hold elbow joint

-Hand at distal wrist (inside of wrist)

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Elbow Flexion -Hand at elbow joint

-Hand inside of wrist

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Forearm Supination -Hand at elbow joint

-Gripping distal wrist OR squeezing with both

hands parallel on either side of forearm

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Forearm Pronation -Hand at elbow joint

-Gripping distal wrist OR squeezing with both

hands parallel on either side of forearm

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Wrist Extension -Stabilize distal wrist on table

-3 fingers below distal metacarpal joints on dorsal

side of hand

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Wrist Flexion -Stabilize distal wrist

-3 fingers below distal metacarpal joints on palm

side of hand