The aim of the project was to compare three methods for measuring muscle strength in individuals with SCI: the manual muscle test (MMT), the hand-held myometry and the isokinetic dynamometry (Cybex). Thirty-eight (38) subjects, 31 men and seven women (age range=14 ± 63; lesion from C5 to L3) were included in this project. Muscle strength assessment of upper limbs was performed at admittance and discharge using MMT and myometry for the left and right side, and using Cybex dynamometer for the stronger side. The testing sessions were at least a day apart and performed by a single evaluator (trained physiotherapist). Signi®cant and non-signi®cant dierences of myometry mean strength values were observed between consecutive levels of MMT. However, the range of myometry scores within each MMT grade led to signi®cant overlaps between two adjacent MMT grades of each muscle group. Variables correlations were observed between the strength values measured by MMT and myometry with paraplegia (0.264r40.67) and tetraplegia (0.504r40.95). Similar results were observed when compared MMT and Cybex with the stronger side.Moderate to strong correlations were observed between the strength values measured by myometry and Cybex with paraplegia (0.704r40.90) and tetraplegia (0.574r40.96). These results suggest that the MMT method does not seem to be suciently sensitive to assess muscle strength, at least for grade 4 and higher and to detect small or moderate increases of strength over the course of rehabilitation. Since outcome measures is an important issue in rehabilitation, objective measurements of strength should be used in clinical settings. Considering cost and assessment time, the myometry technique seems to be highly valuable.

Study Design: Cross-sectional study by mail survey of participation in productive activities of individuals who sustained a spinal cord injury (SCI) in Quebec from 1970 to 1993. Objectives: To determine the level of productivity outcomes of a representative sample and to determine the relationship between the productivity outcomes and some personal and environmental variables. Settings: Quebec, Canada. Methods: Four hundred and eighteen subjects (mean of age=42.1+11.8) were included in this study. Overall productivity was assessed by the participation into ®ve categories of activities (gainful employment, studies, homemaking and family activities, community organizations and leisure activities). Results: Depending on the severity of injury, 30% to 51% of the variance in productivity outcomes can be explained by a set of ten variables: education, ability to drive a car vehicle, other transportation indices, age related variables and type of locomotion. A discriminant analysis was undertaken to classify the subjects into three levels of productivity (low, moderate and high). The percentage of subjects correctly classi®ed was moderate (54% to 71%) to high (72% to 81%) depending on the productivity levels. Conclusion:The results con®rm the signi®cant contribution of education and transportation to explain the productivity outcomes. Sponsorship: This project was funded by the`Socie te d'Assurance Automobile du Que bec', the`Commission de la Sante et de la Se curite du Travail' and the`Fondation Andre Sene cal'.

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