NEUROMUSCULAR POWER PROTOCOL

Strength Station (MMT)

Standardized MRC Scale for Manual Muscle Testing

Gravity Rule: If the patient cannot move against gravity, the maximum possible score is 2/5.

UPPER EXTREMITY MYOTOMES

LOWER EXTREMITY MYOTOMES

CLINICAL MODIFIERS

Select MMT grades (0-5) to
visualize Neuromuscular Output

EMR OBJECTIVE NOTE

The Standard 0-5 MRC MMT Scale

The Manual Muscle Testing (MMT) scale is the universal language for quantifying muscle strength. Developed by the Medical Research Council (MRC), it is essential for diagnosing nerve root impingement and monitoring recovery from peripheral nerve injuries.

Frequently Asked Questions

What does '3+/5' or '4-/5' mean?

These are common clinical "plus/minus" refinements. A 3+/5 indicates the muscle can hold the position against gravity and take *minimal* resistance before breaking. A 4-/5 indicates the muscle can take almost moderate resistance but fails earlier than a true 4/5.

When should I use gravity-eliminated positions?

If a patient cannot initiate movement against gravity, you must place the limb in a horizontal plane (e.g., side-lying for hip abduction) to determine if the strength is 2/5 (full range) or 1/5 (trace contraction).

Is the MMT scale reliable for stroke patients?

MMT is best for lower motor neuron issues. For stroke or UMN lesions where spasticity is present, the Modified Ashworth Scale is often used alongside MMT to get a full picture of motor control.

Clinical Bibliography
  • 1. Medical Research Council. Aids to the examination of the peripheral nervous system. 1943.
  • 2. Kendall FP, et al. Muscles: Testing and Function. 5th ed. 2005.
Dr. Nikhil Mahajan, PT
MPT-Ortho | PT Reviewer

CLINICAL RESOURCE
“

3.5–5.0 mEq/L is the normal range for serum potassium.

— Cleveland Clinic

“

0.6–1.3 mg/dL serum creatinine is normal for most adults.

— Mayo Clinic