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Muscle Testing And Function Florence Kendall 37.pdf !!INSTALL!!


MMT is the most commonly used method for documenting impairments in muscle strength. Limited muscle testing methods are taught in a number of chiropractic schools around the world, however in 2006 a major "stand alone" chiropractic technique that employs MMT for the evaluation of patients known as applied kinesiology chiropractic technique (AK), turned 42 years old. We propose in this review to look at the research status of MMT in the manual examination of the nervous system's status. The early years of the AK method are related elsewhere in detail [3]. The specific protocols and clinical objectives of the technique have been described in previous publications [3-9].




Muscle Testing And Function Florence Kendall 37.pdf



A basic understanding of operational definitions is required in order to make judgments about the methods used in articles and to know which research findings should be implemented in practice. For example, how should we judge the value of the MMT for the gluteus maximus or gluteus medius muscles in cases of sacroiliac joint pain and dysfunction, knowing that statements range from "weakness of the gluteals is usually present in dysfunction of the sacroiliac joint" (Janda 1964) [18] to "the results of this study cast doubt on the suitability of manual muscle testing as a screening test for strength impairments"? (Bohannon 2005) [19].


"Manual muscle tests evaluate the ability of the nervous system to adapt the muscle to meet the changing pressure of the examiner's test. This requires that the examiner be trained in the anatomy, physiology, and neurology of muscle function. The action of the muscle being tested, as well as the role of synergistic muscles, must be understood. Manual muscle testing is both a science and an art. To achieve accurate results, muscle tests must be performed according to a precise testing protocol. The following factors must be carefully considered when testing muscles in clinical and research settings:


MMT procedures are also commonly employed in clinical neurology as a means of subjectively evaluating muscle function. The examiner in the application of force to the subject's resistance evaluates the muscle groups being studied as subjectively "weak" or "strong" on a 5-point scale [24].


MMT is employed by physical therapists to determine the grades of strength in patients with pathological problems and neurologic or physical injuries (strokes, post-polio syndromes, fractures, post-surgical disabilities, etc.). The physical therapist's patients are often initially examined by a medical doctor who supervises the physical therapist's rehabilitation programs that may involve isometric, isokinetic, and isotonic muscle training regimes for the gradual rehabilitation of muscle function (often involving instruments and machinery).


MMT, when employed by AK chiropractors, is used to determine whether manipulable impairments to neurological function (controlling muscle function) exist. For example, chiropractic management using MMT for a patient with carpal tunnel syndrome could involve assessment of the opponens policis and flexor digiti minimi muscles (innervated by the median and radial nerves), and then adjustment as indicated to the carpal bones, the radius and ulna, attention to an inhibited (on MMT) pronator teres muscle, adjustment of the cervical or thoracic spines, and evaluation of cranial nerve XI through MMT of the sternocleidomastoid and upper trapezius muscles. Any or all of these factors may require treatment in order to strengthen the inhibited opponens policis and flexor digiti minimi muscles that are evidence of the carpal tunnel syndrome. This "continuous nervous system" thinking and testing may allow the identification of contributing sites to a pain state.