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Manual Muscle Testing, MMT. Manual Muscle Testing was developed for the first time in the world during the 1860-1880 century by Swedish physiotherapists Clin Rehabil. 1997 Feb;11(1):36-41. Grade 4 in manual muscle testing: the problem with submaximal strength assessment. Dvir Z(1). Author information:OBJECTIVE: To describe the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of manual muscle testing. 19 Dec 2008 1 and Scott C Cuthbert1 The manual muscle test (MMT) has been offered as a chiropractic assessment tool that may help diagnose