Predictive Value of Manual Muscle Testing and Gait Analysis in Normal Ankles by Dynamic Electromyography

Foot & Ankle ◽  
1986 ◽  
Vol 6 (5) ◽  
pp. 254-259 ◽  
Author(s):  
Jacquelin Perry ◽  
Mary Lloyd Ireland ◽  
Jo Gronley ◽  
M. Mark Hoffer
Keyword(s):  
Normal Subjects ◽  
Manual Muscle Testing ◽  
Emg Activity ◽  
Flexor Hallucis Longus ◽  
Muscle Action ◽  
Manual Muscle Test ◽  
Poor Grade ◽  
Muscle Testing ◽  
Grade 3 ◽  
Flexor Digitorum

Eight muscles about the ankle of seven normal subjects were assessed by electromyography (EMG) during manual muscle testing (MMT) and walking. Three strength levels (normal, fair, trace) and three gait velocities (free, fast, slow) were tested. The muscles studied included the gastrocnemius, soleus, posterior tibialis, flexor digitorum longus, flexor hallucis longus, anterior tibialis, extensor digitorum longus, and extensor hallucis longus. Relative intensity of muscle action was quantitated visually (using an eight-point scale based on amplitude and density of the signal). The data showed that EMG activity increased directly as more muscle force was required during the different manual muscle test levels and increased walking speeds. No MMT isolated activity to the specific muscle thought being tested. Instead, there always was a synergistic response. Both the gastrocnemius and soleus contributed significantly to plantarflexion regardless of knee position. The intensity of muscle action during walking related to the manual muscle test grades. Walking at the normal free velocity (meters/min) required fair (grade 3) muscle action. During slow gait the muscle functioned at a poor (grade 2) level. Fast walking necessitated muscle action midway between fair and normal, which was interpreted as good (grade 4).

Tonic and Phasic Discharge Patterns in Toe Flexor γ-Motoneurons During Locomotion in the Decerebrate Cat

2002 ◽  
Vol 87 (1) ◽  
pp. 286-294 ◽  
Author(s):  
P. R. Murphy
Keyword(s):  
Mechanical Action ◽  
Emg Activity ◽  
Flexor Hallucis Longus ◽  
Plantar Flexor ◽  
Step Cycle ◽  
Decerebrate Cat ◽  
Hindlimb Muscles ◽  
Discharge Patterns ◽  
Flexor Digitorum ◽  
Α Activity

To investigate the specificity of fusimotor (γ) drive during locomotion, γ-efferents were recorded from the flexor digitorum longus (FDL) and flexor hallucis longus (FHL) nerves in a decerebrate cat preparation. These nerves innervate hindlimb muscles that differ in some aspects of their mechanical action. For both FHL and FDL two stereotyped patterns of γ activity were distinguished. Tonic units fired throughout the step cycle and had less modulation, but higher minimum rates, than phasic units, which were mainly recruited with ankle extensor [soleus (SOL)] electromyogram (EMG) activity. Differences in the relative timing of these patterns were apparent. In FHL the activity of phasic and most tonic neurons peaked after EMG onset. With FDL, tonic units generally reached maximum rate before, while phasic units peaked after, the beginning of EMG activity. During locomotion FHL and FDL α activity were rhythmically recruited with SOL. However, consistent with previous reports, FHL and FDL differed in their patterns of α activity. FHL was stereotyped while FDL was variable. Both FHL and FDL had activity related to ankle extensor EMG, but only FDL exhibited a peak around the end of this phase. No corresponding γ activity was observed in FDL. In conclusion, 1) FHL and FDL received tonic and phasic fusimotor drive; 2) there was no α/γ linkage for the late FDL α burst; 3) phasic γ-efferents in both muscles received similar inputs, linked to plantar flexor α activity; and 4) tonic γ-efferents differed, to the extent that they were modulated at all. The FHL units peaked with the plantar flexor alphas. The FDL neurons generally peaked before α activity even began.

scholarly journals Relationship between Grade 3 Muscle Strength and the Maximum Muscle Strength in Manual Muscle Testing of Legs: Assessment of Flexion and Extension of the Hip and Knee Joints

2014 ◽  
Vol 29 (6) ◽  
pp. 861-865 ◽  
Author(s):  
Hideyuki USA ◽  
Masashi MATSUMURA ◽  
Daisuke OGAWA ◽  
Masafumi HATA ◽  
Kazuna ICHIKAWA ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Knee Joints ◽  
Manual Muscle Testing ◽  
Muscle Testing ◽  
Grade 3 ◽  
Flexion And Extension

EMG normalization method based on grade 3 of manual muscle testing: Within- and between-day reliability of normalization tasks and application to gait analysis

2018 ◽  
Vol 60 ◽  
pp. 6-12 ◽  
Author(s):  
Anne Tabard-Fougère ◽  
Kevin Rose-Dulcina ◽  
Vincent Pittet ◽  
Romain Dayer ◽  
Nicolas Vuillerme ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Normalization Method ◽  
Manual Muscle Testing ◽  
Muscle Testing ◽  
Grade 3

scholarly journals Effects of Age and Sex on the Results of an Ankle Plantar-Flexor Manual Muscle Test

2005 ◽  
Vol 85 (10) ◽  
pp. 1078-1084 ◽  
Author(s):  
Mei-Hwa Jan ◽  
Huei-Ming Chai ◽  
Yeong-Fwu Lin ◽  
Janice Chien-Ho Lin ◽  
Li-Ying Tsai ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Lower Limb ◽  
Manual Muscle Testing ◽  
Test Results ◽  
Plantar Flexors ◽  
Manual Muscle Test ◽  
Muscle Testing ◽  
Normal Test ◽  
Generating Capacity ◽  
Age And Sex

Abstract Background and Purpose. The ability to perform 20 or more one-leg heel-rises is considered a “normal” grade for muscle strength (force-generating capacity of muscle) of the ankle plantar flexors, regardless of age and sex. Because muscle strength is closely related to age and sex, the “normal” test criterion was re-evaluated in different groups categorized by age and sex. Subjects and Methods. One hundred eighty sedentary volunteers (21–80 years of age) without lower-limb lesions performed as many repetitions of one-leg heel-rise as possible. Lunsford and Perry criteria were used to determine completion of the test. Results. The age and sex of the participants influenced the maximal repetitions of heel-rise, and the repetitions decreased with age and in female subjects. Discussion and Conclusion. The muscle strength of the ankle plantar flexors, as measured by manual muscle testing, varied with age and sex. Clinicians should consider the variances of age and sex when they perform manual muscle testing of the ankle plantar flexors.

Internal Consistency of Manual Muscle Testing Scores

1997 ◽  
Vol 85 (2) ◽  
pp. 736-738 ◽  
Author(s):  
Richard W. Bohannon
Keyword(s):  
Muscle Strength ◽  
Lower Extremity ◽  
Home Care ◽  
Internal Consistency ◽  
Test Scores ◽  
Manual Muscle Testing ◽  
Limb Muscle ◽  
Manual Muscle Test ◽  
Muscle Testing

The internal consistencies of manual muscle test scores of the actions of three upper and three lower extremity muscles were examined among 37 home care patients. The correlations between scores of specific pairs of actions ranged from .01 to .88. Cronbach alphas ranged from .59 to .88. Manual scores of limb muscle strength, therefore, appear to possess suitable internal consistency.

scholarly journals Manual Muscle Testing—Force Profiles and Their Reproducibility

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 996
Author(s):  
Frank Bittmann ◽  
Silas Dech ◽  
Markus Aehle ◽  
Laura Schaefer
Keyword(s):  
Diagnostic Tool ◽  
Applied Force ◽  
Manual Muscle Testing ◽  
Manual Muscle Test ◽  
Handheld Device ◽  
Muscle Testing ◽  
Temporal Course ◽  
Force Profile ◽  
Euclidean Distances ◽  
Force Profiles

The manual muscle test (MMT) is a flexible diagnostic tool, which is used in many disciplines, applied in several ways. The main problem is the subjectivity of the test. The MMT in the version of a “break test” depends on the tester’s force rise and the patient’s ability to resist the applied force. As a first step, the investigation of the reproducibility of the testers’ force profile is required for valid application. The study examined the force profiles of n = 29 testers (n = 9 experiences (Exp), n = 8 little experienced (LitExp), n = 12 beginners (Beg)). The testers performed 10 MMTs according to the test of hip flexors, but against a fixed leg to exclude the patient’s reaction. A handheld device recorded the temporal course of the applied force. The results show significant differences between Exp and Beg concerning the starting force (padj = 0.029), the ratio of starting to maximum force (padj = 0.005) and the normalized mean Euclidean distances between the 10 trials (padj = 0.015). The slope is significantly higher in Exp vs. LitExp (p = 0.006) and Beg (p = 0.005). The results also indicate that experienced testers show inter-tester differences and partly even a low intra-tester reproducibility. This highlights the necessity of an objective MMT-assessment. Furthermore, an agreement on a standardized force profile is required. A suggestion for this is given.

A longitudinal physical profile assessment of skeletal muscle manifestations in myotonic dystrophy

1999 ◽  
Vol 13 (1_suppl) ◽  
pp. 64-73 ◽  
Author(s):  
JC Nitz ◽  
YR Burns ◽  
RV Jackson
Keyword(s):  
Skeletal Muscle ◽  
Myotonic Dystrophy ◽  
Upper Limb ◽  
Normal Subjects ◽  
Respiratory Function Tests ◽  
Forced Expiratory Volume ◽  
Manual Muscle Testing ◽  
Pinch Grip ◽  
Muscle Testing ◽  
Physical Profile

Objectives: To develop an assessment that describes the skeletal muscle manifestations in myotonic dystrophy subjects and then use it to quantify the presentation of skeletal muscle disability and to show change over time. Design: A quantified skeletal muscle assessment was developed and applied three times over a two-year period at intervals around 12 months. Thirty-six subjects with myotonic dystrophy and 20 subjects without neuromuscular disability were evaluated. The assessment comprised manual muscle testing of five pairs of muscles, measuring neck flexor strength with a strain gauge, respiratory function tests, power and lateral pinch grip strength, all tests of impairment. Assessment of the ability to move from sitting to standing and fasten buttons tested disability. Results: Results from subjects with myotonic dystrophy were compared to the normal data. The subjects with myotonic dystrophy were significantly weaker in proximal upper limb muscles, quadriceps, tibialis anterior muscles and neck flexor muscles as well as power and lateral pinch grips. There was also significant reduction in forced expiratory volume at one second (FEV1) and forced vital capacity (FVC). Significant disability was seen in the myotonics in moving from sitting to standing and in fastening buttons. Over the two-year study period proximal upper limb and lower limb muscle strength, FVC and sit-to-stand ability declined significantly. Power grip declined but lateral pinch grip and FEV1 improved significantly. Button fastening ability improved significantly. Conclusion: The test developed was shown to be reliable and sensitive to the change in skeletal muscle manifestations in subjects with myotonic dystrophy who were shown to be significantly weaker than normal subjects.

scholarly journals Manual Muscle Testing – Force Profiles and Their Reproducibility

2020 ◽  
Author(s):  
Frank N Bittmann ◽  
Silas Dech ◽  
Markus Aehle ◽  
Laura V Schaefer
Keyword(s):  
Diagnostic Tool ◽  
Applied Force ◽  
Manual Muscle Testing ◽  
Manual Muscle Test ◽  
Handheld Device ◽  
Muscle Testing ◽  
Temporal Course ◽  
Force Profile ◽  
Euclidean Distances ◽  
Force Profiles

The manual muscle test (MMT) is a flexible diagnostic tool, which is used in many disciplines, applied in several ways. The main problem is the subjectivity of the test. The MMT in the version of a “break test” depends on the tester’s force rise and the patient’s ability to resist the applied force. As a first step, the investigation of the reproducibility of the testers’ force profiles is required for valid application. The study examined the force profiles of n=29 testers (n=9 experiences (Exp), n=8 little experienced (LitExp), n =12 beginners (Beg)). The testers performed 10 MMTs according to the test of hip flexors, but against a fixed leg to exclude the patient’s reaction. A handheld device recorded the temporal course of the applied force. The results show significant differences between Exp and Beg concerning the starting force (padj=0.029), the ratio of starting to maximum force (padj=0.005) and the normalized mean Euclidean distances between the 10 trials (padj=0.015). The slope is significantly higher in Exp vs. LitExp (p=0.006) and Beg (p=0.005). The results also indicate that experienced testers show inter-tester differences and partly even a low intra-tester reproducibility. That highlights the necessity of an objective MMT-assessment. Furthermore, an agreement on a standardized force profile is required – a suggestion is given.

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