Comparison of three methods to assess muscular strength in individuals with spinal cord injury

Abstract

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.

Isokinetic Muscle Performance Test Can Predict the Status of Rotator Cuff Muscle

“…We found a low correlation between the IMPT and MMT although the latter was performed by one orthopaedic surgeon. Similarly, in previous studies, only weak correlations between the MMT and IMPT were reported [12,18]. Numerous factors affect muscle strength including pain and ROM; however, muscle strength as determined by the MMT provides only limited and indistinct information regarding the tear size or FD of the rotator cuff muscle.…”

Physical capacity in wheelchair-dependent persons with a spinal cord injury: a critical review of the literature

“…77 Thirdly, it is limited in the ability to identify change for grades 4 and Literature review of physical capacity in spinal cord injury JA Haisma et al 5, and the registration of recovery is restricted by a ceiling effect. 49,52,[77][78][79] Fourthly, it seems less valid, because it has a limited correlation with isokinetic dynamometry, which is often regarded the gold standard for the assessment of muscle strength, but is not manageable in use. 44,77,80 The HHD score has shown to be valid, and has a good reliability in SCI, both with experienced and inexperienced examiners.…”

“…49,52,[77][78][79] Fourthly, it seems less valid, because it has a limited correlation with isokinetic dynamometry, which is often regarded the gold standard for the assessment of muscle strength, but is not manageable in use. 44,77,80 The HHD score has shown to be valid, and has a good reliability in SCI, both with experienced and inexperienced examiners. 44,47,49 Muscle strength is an important component of physical capacity, and is related to functioning.…”

How do C6/C7 tetraplegic patients grasp balls of different sizes and weights? Impact of surgical musculo-tendinous transfers

“…At each session, a clinical testing of the muscles of the arm was performed, 16 and the patient was assigned to one of the three following groups according to the score of the TB and to the patient's progress in the surgical programme.…”

“…10,14 The tests aiming to evaluate the impairment of the hand are limited to the measurement of strength and joint motion. 11,[15][16][17] Most of the tests for the evaluation of the motor capacity of the hand 7,10,11,[18][19][20][21] are only performance tests and give no details on hand grip configurations during prehension. More global functional evaluations assess many functions in addition to hand performance 2,22,23 and are sensitive to additional variables (eg motivation, choice of the tasks or choice of the objects).…”