JUVENILE MYOSITIS: STANDARDIZATION OF MMT8 COMMANDS.
The following are suggested commands for manual muscle testing in pediatric patients.
Variation in the text is acceptable, but the concepts are intended to be uniform between
patients. The instructions would be different for gravity-eliminated testing:
I’m going to see how strong you are. When I tell you hold and don’t let me push you, you try
really, really hard not to let me move you. You need to be strong like a tree or a power ranger
(use these examples to motivate the child).
1. Deltoid middle: Hold your arm up in the air like this (demonstrate), and I’m going to push
down here and you hold it. Don’t let me push it down, hold it up there as hard as you
can.
2. Biceps brachii: Bend your elbow, now don’t let me pull your arm down. Hold it hard and
don’t let me pull it out.
3. Wrist extensors: Bring your hand back like this (demonstrate) and hold it while I try to
straighten it out. Don’t let me straighten your hand. Be strong.
4. Quadriceps: (Sitting) Kick your leg out so it is straight. Now hold it straight while I try to
bend your knee. Be strong and keep it straight.
5. Ankle dorsiflexors: Bring your foot up like this (demonstrate), now hold it while I try to
push it down. Don’t let me push it down.
6. Neck flexors: (Supine) Bring your head up off the table, now hold it up there. Now hold it
up there while I try to push it down and don’t let me push it. Hold it as hard as you can.
7. Gluteus medius: Can you lie on your side? Now can you lift your leg up in the air? Make
sure you keep your knee straight. Now hold it up there while I try to push your leg. Hold it
hard and be strong.
8. Gluteus maximus: Lie on your belly, and bend your knee. Now try to lift your whole leg
up in the air (demonstrate passively). Hold it there, while I try to push down and don’t let
me push it down. Hold it hard.
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