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2 - MMT Elbow Flexor

This document describes how to perform muscle testing of the elbow flexors (biceps, brachialis, and brachioradialis muscles). It outlines the positioning of the patient and therapist for each test, provides instructions to the patient, and defines the grading system from 5 (normal) to 0 (zero). Muscle testing involves resisting elbow flexion in different forearm positions to isolate each muscle while grading the strength on a scale from full range of motion against resistance to no palpable muscle activity.

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393 views20 pages

2 - MMT Elbow Flexor

This document describes how to perform muscle testing of the elbow flexors (biceps, brachialis, and brachioradialis muscles). It outlines the positioning of the patient and therapist for each test, provides instructions to the patient, and defines the grading system from 5 (normal) to 0 (zero). Muscle testing involves resisting elbow flexion in different forearm positions to isolate each muscle while grading the strength on a scale from full range of motion against resistance to no palpable muscle activity.

Uploaded by

DaniJaral
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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MUSCLE TESTING

Elbow flexion
ELBOW FLEXION

 Main muscles of elbow flexion are


Biceps,
Brachialis
Brachioradialis
ELBOW FLEXION
NERVE SUPPLY
GRADE 5 (NORMAL), GRADE 4
(GOOD), AND GRADE 3 (FAIR)
 Position of patient :
 Short sitting with arms at sides.

 Biceps brachii:
 Forearm in supination

 Brachialis:
 Forearm in pronation

 Brachioradialis:
 Forearm in mid position between pronation and supination
Resisted flexion with forearm
in supination and pronation
GRADE 5 (NORMAL), GRADE 4
(GOOD), AND GRADE 3 (FAIR)

 Position of Therapist:
 Stand in front of patient toward the test side.
 Hand giving resistance is contoured over the flexor
surface of the forearm proximal to the wrist.
 The other hand applies counter force by cupping the
palm over the anterior superior surface of the shoulder.
Position of therapist
INSTRUCTIONS TO PATIENT
(ALL THREE TEST)

 Grades 5 and 4: "Bend your elbow. Hold it. Don't


let me pull it down. "

 Grade 3: "Bend your elbow. "


GRADING

 Grade 5 (Normal): Completes available range and


holds firmly against maximal resistance.

 Grade 4 (Good): Completes available range against


strong to moderate resistance, but the end point may
not be firm.

 Grade 3 (Fair): Completes available range in each


forearm position with no manual resistance.
Position for grade 3
GRADE 2 (POOR)

 Position of Patient:
 All Elbow Flexors: Short sitting with arm abducted to 90° and
supported by examiner.
 Forearm is Supinated (biceps),
Pronated (brachialis), and in
Midposition (brachioradialis).

 Alternate position for grade 2 test


Position of Patient:
 Supine: Elbow is flexed to about 45 °with

- Supinated (for biceps)


- Pronated (for brachialis),
- Mid position (for brachioradialis)
Alternate position for grade 2 test
Position of therapist for grade 2

 All Three Flexors:


Palpate the tendon of the biceps in the antecubital
space.

Palpate the brachialis in the distal arm medial to


the tendon of the biceps.

Palpate the brachioradialis on the proximal volar


surface of the forearm , where it forms the lateral
border of the cubital fossa .
GRADE 1 (TRACE) AND GRADE 0
(ZERO)

 Positions of Patient and Therapist:


Supine for all three muscles with therapist
standing at test side

 Test:
Patientattempts to bend elbow with hand
supinated, pronated , and in midposition.
 Test:
Patient attempts to flex the elbow.

 Instructions to Patient:
"Try to bend your elbow. "
GRADING

 Grade 2 (Poor): Completes range of motion (in


each of the muscles tested).

 Grade 1 (Trace): Examiner can palpate a


contractile response in each of the three muscles
for which a Trace grade is given.

 Grade 0 (Zero): No palpable contractile activity.


THANK YOU

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