A Comparison of Manual and Quantitative Elbow Strength Testing

Shahgholi, Leili; Bengtson, Keith A.; Bishop, Allen T.; Shin, Alexander Y.; Spinner, Robert J.; Basford, Jeffrey R.; Kaufman, Kenton R.

doi:10.1097/phm.0b013e31825f14f9

Cited by 35 publications

(16 citation statements)

References 6 publications

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“…Ankle muscle strength in sciatica patients is usually evaluated by manual muscle testing (MMT), which can be performed easily and does not require any instruments. MMT is graded from 0 (no contrac-tion) to 5 (normal strength) and it is useful in determining ankle muscle weakness ranging from 0 to 3 [4,5]. But the sensitivity of MMT is low in determining ankle muscle weakness ranging from 4 to 5; therefore grading is generally extended as 4−, 4, 4+, 5−, and 5 [6].…”

Section: Introductionmentioning

confidence: 99%

Association with isokinetic ankle strength measurements and normal clinical muscle testing in sciatica patients

Üstün

Erol

Özçakar

et al. 2013

BMR

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Section: Introductionmentioning

confidence: 99%

Association with isokinetic ankle strength measurements and normal clinical muscle testing in sciatica patients

Üstün

Erol

Özçakar

et al. 2013

BMR

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“…Thus far, prospective literature on strength deficits from lumbosacral disk herniation has used the highly subjective manual muscle testing (MMT) as its primary measurement. Although MMT is a commonly used exam maneuver for assessing strength deficits by clinicians, it is frequently confounded by numerous variables . One of the biggest issues with MMT is that strength deficit may not be detected, particularly in antigravity muscles .…”

Section: Introductionmentioning

confidence: 99%

“…Although MMT is a commonly used exam maneuver for assessing strength deficits by clinicians, it is frequently confounded by numerous variables. 16 One of the biggest issues with MMT is that strength deficit may not be detected, particularly in antigravity muscles. 17 Performance-based strength testing and handheld dynamometry (HHD) assess muscle function methodically and may detect subtler strength deficits.…”

Section: Introductionmentioning

confidence: 99%

Clinical Course of Motor Deficits from Lumbosacral Radiculopathy Due to Disk Herniation

Akuthota

Marshall

Boimbo

et al. 2019

PM&R

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Background The clinical course of motor deficits from lumbosacral radiculopathy appears to improve with or without surgery. Strength measurements have been confined to manual muscle testing (MMT) and have not been extensively followed and quantified in prior studies. Objective To determine if motor weakness and patient‐reported outcomes related to lumbosacral radiculopathy improve without surgical intervention over the course of 12 months. Design Prospective observational cohort. Setting Outpatient academic spine practice. Participants Adults with acute radicular weakness due to disk herniation. Methods Forty patients with radiculopathy and strength deficit were followed over a 12‐month period. Objective strength and performance tests as well as survey‐based measurements were collected at baseline and then every 3 months. Patients underwent comprehensive pain management and rehabilitation and/or surgical approaches as determined in coordination with the treating specialist. This study was approved by the institutional review board of Colorado. Main Outcome Measurements Testing of strength was through MMT, handheld dynamometer, and performance‐based testing. Furthermore, visual analog scale, modified Oswestry Disability Index, and 36‐Item Short Form Health Survey (SF‐36) were used to measure pain and disability outcomes. Results Of the 40 patients, 33 (82.5%) did not have surgery; 7 (17.5%) had surgery. Twenty‐four of the 33 patients (60%) did not undergo surgery and were followed for 12 months (Comprehensive Pain Management and Rehabilitation, Complete [CPM&R‐C]), and 9 (22%) did not have surgery and lacked at least one follow‐up evaluation (Comprehensive Pain Management and Rehabilitation, Incomplete [CPM&R‐I]). No statistically significant differences were found on baseline measures of strength deficits and SF‐36 domains between the CPM&R‐C, Surgery, and CPM&R‐I groups. Pain and disability scores in the Surgery group were significantly higher than in the CPM&R‐C at baseline. There were statistically significant improvements in all areas of strength, pain, and function when comparing measurements at the 12‐month follow‐up to baseline in the CPM&R‐C group. Conclusions Individuals with motor deficits due to lumbosacral radiculopathy improve over time regardless of treatment choice. Most did not choose surgery, and almost all of these patients regained full strength at 1 year. Strength recovery typically occurred in the first 3 months, but there was ongoing recovery over the course of a year. Level of Evidence II

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“…However, the MMT has some limitations: it is inaccurate (11,12), subjective, when muscular strength is rated as good or normal (12,13,14), and shows low responsiveness (12,15). Therefore, to accurately assess strength, it is necessary to apply a valid (16), reliable (11,15), and sensitive (11) method, that provides objective measures (11,17), such as portable dynamometry.…”

Section: Introductionmentioning

confidence: 99%

“…Portable dynamometers are commonly used in research (18) and, in some situations, within clinical settings. They are easy-to-use devices and to perform the tests, the device is positioned between the examiner's hand and the muscular group under assessment, similar to the MMT assessment (12,18). Some factors may influence the measures obtained with portable dynamometers (19), such as positioning of the subjects and the device, number of trials, contraction and resting times, prior demonstration and familiarization with the procedures, and supply of verbal or visual encouragements.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the strength of the lower limb muscles in subjects with stroke with portable dynamometry: a literature review

et al. 2016

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Introduction: Weakness of the lower limb muscles, which are the main impairments after stroke, is associated with reduced mobility and decreased performance in functional tasks. Therefore, the assessment of strength of these muscles is necessary, which is commonly assessed with portable dynamometry. Aims: To perform a literature review regarding the methods used to assess lower limb strength with portable dynamometry in subjects with stroke and to describe its investigated measurement properties with this population. Materials and Methods: An extensive search was performed on the MEDLINE, SCIELO, LILACS, and PEDro databases, by combining specific key words, followed by active manual search by two independent researchers. Results and Discussion: Thirty studies were included, and the muscular groups of the knee (90%) were the most assessed, followed by the ankle (66.7%) and hip (63.3%) joints. In 5% of the studies, there were not reported any descriptions related to the positioning of the subjects and the equipment, neither regarding the stabilization procedures. Only 50% provided information regarding the number of trials and only 46.7% regarding the contraction times, being three trials and 5s the most commonly applied. Only 10% provided feedback and 23.3% demonstrations, prior to data collection. Only seven studies (23.3%) investigated the measurement properties of portable dynamometry and reported moderate to high reliability levels. Final Considerations: The protocols used for the assessment of the strength of the lower limb muscles with portable dynamometry in subjects with stroke were not standardized. Moreover, only one measurement property was investigated: the reliability, which was considered adequate.

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A Comparison of Manual and Quantitative Elbow Strength Testing

Abstract: Manual muscle testing, even when performed by experienced clinicians, may be more misleading than expected for subjects graded as having normal (5/5) strength. Manual muscle testing estimates for the lesser strength grades (1-4/5) seem reasonably accurate.

Cited by 35 publications

References 6 publications

Association with isokinetic ankle strength measurements and normal clinical muscle testing in sciatica patients

Association with isokinetic ankle strength measurements and normal clinical muscle testing in sciatica patients

Clinical Course of Motor Deficits from Lumbosacral Radiculopathy Due to Disk Herniation

Assessment of the strength of the lower limb muscles in subjects with stroke with portable dynamometry: a literature review

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