Test Positioning

It is very important to use bony landmarks and proper positioning for ROM. This is because there HAS to be a universal standard for positioning or else ROM measurements may be very "off." This is especially important when 2 different therapists are working with a client - both therapists must use the same positioning or else the measurements will not be accurate in terms of documentation, showing ROM progress that has been made. ROM measurements are very exact, in that a slight difference in positioning can severely affect goniometer results. Next, test positioning for MMT is widely important as well. Like ROM, there must also be a universal standard for MMT, or else measurements would be "off." If a patient is relatively strong, testing them against gravity is great because it makes the movement that much more difficult, pushing them to try a little harder. If a patient is extremely weak, they may not be able to flex their bicep against gravity, so they would need to do the motion in a gravity-eliminated way (parallel to the ground). Testing MMT in a gravity-eliminated movement takes out the force of gravity that really pulls on our muscles in all hours of the day. I think gravity-eliminated MMT is an awesome way to know the true muscle strength of a muscle, because no other external fore is acting on it. In addition, a patient might be able to do full ROM at a joint in a gravity eliminated position rather than in an against gravity position. Getting a patient to work on this full ROM in a gravity eliminated position helps to work that joint and the muscles involved, so that eventually they might be able to do the full ROM in an against gravity position. Finally, the therapist must make sure the exact same MMT position is used when he or she tests the patient again to track progress made.