Strength post-spinal cord injury: myometer vs manual muscle test

Abstract

This study was designed to compare changes in strength after spinal cord injury (SCI) with the use of a hand held myometer to the manual muscle test (MMT). Eighty-eight C4-C8 Frankel A-D tetraplegic subjects were tested at various times up to 2 years post-SCI. Elbow flexor strength on successive examinations were grouped according to their early and later MMT scores (3.5 with no change in MMT, 3.5 to 4.0, and 3.5 to 4.5; 4.0 with no change in MMT, 4.0 to 4.5, and 4.0 to 5.0; 4.5 with no change in MMT, and 4.5 to 5.0). For each group, later myometric measurements (MYO) were expressed as percents of their earlier MYO and were anlayzed using paired Students t-tests. Later MYO were 116, 205, 232% (P>0.05, P<0.002, P<0.05) of their earlier MYO for groups 3.5 with no change in the MMT, 3.5 to 4.0, and 3.5 to 4.5 respectively. Later MYO were 140, 139, 191 % (P<0.05, P<0.02, P<O.OOOl) of their earlier MYO for groups 4.0 with no change in MMT, 4.0 to 4.5, and 4.0 to 5.0 respectively. Later MYO were 127 and 126% (P<O.OI, P<0.02) of their earlier MYO for groups 4.5 with no change in MMT and 4.5 to 5.0 respectively. In conclusion the hand held myometer detected changes in muscle strength not detected by the MMT.

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

“…44 The elbow flexion in subjects with tetraplegia ranged from 4.0 to 9.2 kg. 47,49,52 The mean strength for wrist extension was 6.5 kg. 47 Elbow extension scored between 8.0 and 11.1 kg.…”

“…48 Elbow flexion ranged from a grade 2 to 5. [45][46][47]49,52 Wrist extension ranged from 3.3 to 4. 45,52 Elbow extension ranged from 0 to 2.…”

“…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.…”

Level walking and ambulatory capacity in persons with incomplete spinal cord injury: relationship with muscle strength

“…We evaluated the test-retest reliability (separate days) for manual muscle testing in a small group (N ¼ 8) of individuals with SCI and found the intraclass correlations to be 0.82-0.99 for the eight lower limb muscle groups. Others [15][16][17] have also reported high reliability for upper and lower limb manual muscle testing in persons with SCI. The ASIA lower extremity muscle score (LEMS) was derived from Trace muscle contraction 1.5…”

“…13 Procedures A physical therapist performed the manual muscle test on each subject for eight lower limb muscle groups (hip flexors/extensors/abductors, knee flexors/extensors, ankle dorsiflexors/plantarflexors, and great toe extensors) in standardized positions. 14 Muscle strength was graded on a scale from zero to five using 10 intervals as per Herbison et al 15 (Table 2). We evaluated the test-retest reliability (separate days) for manual muscle testing in a small group (N ¼ 8) of individuals with SCI and found the intraclass correlations to be 0.82-0.99 for the eight lower limb muscle groups.…”