Quantification of Wrist Flexors Strength by Hand-Held Dynamometer with Respect to Grades of Manual Muscle Testing in Young Females

Objective: To compare accuracy of manual muscle testing in detection of strength differences across grade 4 and 5 at different percentage deficits of dynamometric mean in shoulder flexors of young females. Methods: Cross sectional research design, conducting primary analysis of strength of shoulder flexors measured through manual muscle testing and hand-held dynamometer. Three hundred young healthy females without any ailment of upper extremity or generalized health problem were selected from University of South Asia and Association of Fatima Jinnah Old Graduates, Lahore. Non-probability convenient sampling technique was used. The age group selected was 18-39 years. The strength of shoulder flexors measured through manual muscle testing and hand-held dynamometer was main outcome measure. Results: The overall diagnostic accuracy of manual muscle testing showed better results at 10% dynamometric measures. It was 63.33%(95% CI: 57.74%, 68.59%) in non-dominant shoulder flexors and 61.67% (95% CI: 56.05%, 66.99%) in dominant shoulder flexors. The positive predictive value (PPV) and specificity of manual muscle testing was better at 10% strength deficit in comparison with dynamometric measures, whereas negative predictive value (NPV) and sensitivity was better at 20% strength deficit. Contrasting association was found between positive predictive value (PPV) and sensitivity, negative predictive value and specificity. Conclusion: The subjective area of grade 4 and 5 showed better, although not ideal, diagnostic worth at 10% deficit of dynamometric measures in shoulder flexors. Further exploration through study of contrasting trends between PPV and sensitivity by subgroup analysis is required. Continuous...

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Quick Reference: Chapter 3: The Musculoskeletal System and Chapter 4: The Nervous System

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2000.mayjun03 ◽

2000 ◽

Vol 5 (3) ◽

pp. 4-4

Keyword(s):

Nervous System ◽

Lower Extremity ◽

Musculoskeletal System ◽

Multistep Method ◽

Manual Muscle Testing ◽

Motor Deficits ◽

Lower Extremity Weakness ◽

Residual Symptoms ◽

Muscle Testing ◽

Almost All

Abstract Lesions of the peripheral nervous system (PNS), whether due to injury or illness, commonly result in residual symptoms and signs and, hence, permanent impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, divides PNS deficits into sensory and motor and includes pain in the former. This article, which regards rating sensory and motor deficits of the lower extremities, is continued from the March/April 2000 issue of The Guides Newsletter. Procedures for rating extremity neural deficits are described in Chapter 3, The Musculoskeletal System, section 3.1k for the upper extremity and sections 3.2k and 3.2l for the lower limb. Sensory deficits and dysesthesia are both disorders of sensation, but the former can be interpreted to mean diminished or absent sensation (hypesthesia or anesthesia) Dysesthesia implies abnormal sensation in the absence of a stimulus or unpleasant sensation elicited by normal touch. Sections 3.2k and 3.2d indicate that almost all partial motor loss in the lower extremity can be rated using Table 39. In addition, Section 4.4b and Table 21 indicate the multistep method used for spinal and some additional nerves and be used alternatively to rate lower extremity weakness in general. Partial motor loss in the lower extremity is rated by manual muscle testing, which is described in the AMA Guides in Section 3.2d.

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INTERNAL CONSISTENCY OF MANUAL MUSCLE TESTING SCORES

Perceptual and Motor Skills ◽

10.2466/pms.85.6.736-738 ◽

1997 ◽

Vol 85 (6) ◽

pp. 736 ◽

Cited By ~ 6

Author(s):

RICHARD W. BOHANNON

Keyword(s):

Internal Consistency ◽

Manual Muscle Testing ◽

Muscle Testing

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Impact of structured physical therapy intervention on functional recovery in a patient with CAPOS syndrome: a case report

Bulletin of Faculty of Physical Therapy ◽

10.1186/s43161-021-00026-y ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Shailesh Gardas ◽

Aishwarya Mahajan

Keyword(s):

Functional Performance ◽

Functional Independence Measure ◽

Functional Independence ◽

Measurement Scale ◽

Manual Muscle Testing ◽

Trunk Control ◽

Control Measurement ◽

Muscle Testing ◽

Post Test ◽

Capos Syndrome

Abstract Background CAPOS syndrome (cerebellar ataxia, areflexia, pescavus, optic atrophy, and sensorineural hearing loss) is a rare congenital autosomal dominant disorder. The resulting neurological sequelae of impairments are progressive in nature and may interfere with functional independence, performing activities of daily living (ADL’s), and subsequently, affecting the quality of life (QOL). Since it is an extremely rare disorder, there is a severe dearth in the literature about how specific physiotherapy interventions may affect their functional status. Therefore, our objective was to investigate the effects of proprioceptive neuromuscular facilitation (PNF) and Frenkel’s coordination exercises on functional recovery in a patient with CAPOS syndrome. Case presentation We herein present a case of a 25-year-old Indian male with complaints of generalized body weakness, difficulty visualizing distant objects, nystagmus, progressive sensorineural deafness, and ataxia. He was rehabilitated with a structured/customized physiotherapy protocol consisting of PNF approach and coordination exercises for 4 weeks, 6 days/week, 60 min daily. An improvement in overall functional performance of patient as per post-intervention scores of manual muscle testing, trunk control measurement scale, functional independence measure (components of self-care, transfers, and locomotion), and decline in severity of ataxia on scale for assessment and rating of ataxia scale was observed. Conclusion PNF and Frenkel’s exercises resulted in an improvement in overall functional performance of the patient. Improvement was observed in post-test scores of Manual Muscle Testing (MMT), Trunk Control Measurement Scale (TCMS), and Functional Independence Measure (FIM) for the components of self-care, transfers, and locomotion. Additionally, results also showed a decline in severity of ataxia on post-test scores of scale for the assessment and rating of ataxia (SARA) scale (i.e., from severe to moderate).

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Integration of focal vibration and intra-articular oxygen–ozone therapy in rehabilitation of painful knee osteoarthritis

Journal of International Medical Research ◽

10.1177/0300060520986705 ◽

2021 ◽

Vol 49 (2) ◽

pp. 030006052098670

Author(s):

Teresa Paolucci ◽

Francesco Agostini ◽

Andrea Bernetti ◽

Marco Paoloni ◽

Massimiliano Mangone ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Knee Injury ◽

Medical Research Council ◽

Group Analysis ◽

Manual Muscle Testing ◽

Ozone Therapy ◽

Analog Scale ◽

Daily Life Activities ◽

Muscle Testing ◽

End Of Treatment

Objective To examine the pain-reducing effects of intra-articular oxygen–ozone (O2O3) injections and mechanical focal vibration (mFV) versus O2O3 injections alone in patients with knee osteoarthritis. Methods Patients with chronic pain (>6 weeks) due to knee osteoarthritis (II–III on the Kellgren–Lawrence scale) were consecutively enrolled and divided into two groups: O2O3 (n = 25) and O2O3-mFV (n = 24). The visual analog scale (VAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Medical Research Council (MRC) Manual Muscle Testing scale were administered at baseline (before treatment), after 3 weeks of treatment, and 1 month after the end of treatment. Patients received three once-weekly intra-articular injections of O2O3 into the knee (20 mL O3, 20 μg/mL). The O2O3-mFV group also underwent nine sessions of mFV (three sessions per week). Results The VAS score, KOOS, and MRC score were significantly better in the O2O3-mFV than O2O3 group. The within-group analysis showed that all scores improved over time compared with baseline and were maintained even 1 month after treatment. No adverse events occurred. Conclusion An integrated rehabilitation protocol involving O2O3 injections and mFV for 3 weeks reduces pain, increases autonomy in daily life activities, and strengthens the quadriceps femoris.

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The Effect of Bedding System Selected by Manual Muscle Testing on Sleep-Related Cardiovascular Functions

BioMed Research International ◽

10.1155/2013/937986 ◽

2013 ◽

Vol 2013 ◽

pp. 1-12 ◽

Cited By ~ 2

Author(s):

Terry B. J. Kuo ◽

Jia-Yi Li ◽

Chun-Ting Lai ◽

Yu-Chun Huang ◽

Ya-Chuan Hsu ◽

...

Keyword(s):

Muscle Power ◽

Cardiovascular Effects ◽

Manual Muscle Testing ◽

Vagal Activity ◽

Double Blind ◽

Muscle Testing ◽

Sympathetic Modulation ◽

Sleep Log ◽

Baroreceptor Reflex Sensitivity ◽

Cardiovascular Functions

Background. Different types of mattresses affect sleep quality and waking muscle power. Whether manual muscle testing (MMT) predicts the cardiovascular effects of the bedding system was explored using ten healthy young men.Methods. For each participant, two bedding systems, one inducing the strongest limb muscle force (strong bedding system) and the other inducing the weakest limb force (weak bedding system), were identified using MMT. Each bedding system, in total five mattresses and eight pillows of different firmness, was used for two continuous weeks at the participant’s home in a random and double-blind sequence. A sleep log, a questionnaire, and a polysomnography were used to differentiate the two bedding systems.Results and Conclusion. Heart rate variability and arterial pressure variability analyses showed that the strong bedding system resulted in decreased cardiovascular sympathetic modulation, increased cardiac vagal activity, and increased baroreceptor reflex sensitivity during sleep as compared to the weak bedding system. Different bedding systems have distinct cardiovascular effects during sleep that can be predicted by MMT.

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Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients

Journal of Visualized Experiments ◽

10.3791/2632 ◽

2011 ◽

Cited By ~ 7

Author(s):

Nancy Ciesla ◽

Victor Dinglas ◽

Eddy Fan ◽

Michelle Kho ◽

Jill Kuramoto ◽

...

Keyword(s):

Muscle Strength ◽

Critically Ill ◽

Critically Ill Patients ◽

Manual Muscle Testing ◽

Muscle Testing

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FRI0627-HPR In Patients with Inflammatory Myopathy Quantitative Muscle Testing Has A Higher Reliability than Manual Muscle Testing

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-eular.1387 ◽

2016 ◽

Vol 75 (Suppl 2) ◽

pp. 1281.1-1281

Author(s):

I. Sterkele ◽

P. Baschung Pfister ◽

E.D. de Bruin ◽

B. Maurer ◽

R.H. Knols

Keyword(s):

Inflammatory Myopathy ◽

Manual Muscle Testing ◽

Muscle Testing

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Mapping intended spinal site of care from the upright to prone position: an interexaminer reliability study

Chiropractic & Manual Therapies ◽

10.1186/2045-709x-22-20 ◽

2014 ◽

Vol 22 (1) ◽

Cited By ~ 2

Author(s):

Robert Cooperstein ◽

Morgan Young

Keyword(s):

Prone Position ◽

Mean Squared Error ◽

Thought Experiment ◽

Spinous Process ◽

Intraclass Correlation ◽

Manual Muscle Testing ◽

Muscle Testing ◽

Interexaminer Reliability ◽

Novel Method ◽

The Mean

Abstract Background Upright examination procedures like radiology, thermography, manual muscle testing, and spinal motion palpation may lead to spinal interventions with the patient prone. The reliability and accuracy of mapping upright examination findings to the prone position is unknown. This study had 2 primary goals: (1) investigate how erroneous spine-scapular landmark associations may lead to errors in treating and charting spine levels; and (2) study the interexaminer reliability of a novel method for mapping upright spinal sites to the prone position. Methods Experiment 1 was a thought experiment exploring the consequences of depending on the erroneous landmark association of the inferior scapular tip with the T7 spinous process upright and T6 spinous process prone (relatively recent studies suggest these levels are T8 and T9, respectively). This allowed deduction of targeting and charting errors. In experiment 2, 10 examiners (2 experienced, 8 novice) used an index finger to maintain contact with a mid-thoracic spinous process as each of 2 participants slowly moved from the upright to the prone position. Interexaminer reliability was assessed by computing Intraclass Correlation Coefficient, standard error of the mean, root mean squared error, and the absolute value of the mean difference for each examiner from the 10 examiner mean for each of the 2 participants. Results The thought experiment suggesting that using the (inaccurate) scapular tip landmark rule would result in a 3 level targeting and charting error when radiological findings are mapped to the prone position. Physical upright exam procedures like motion palpation would result in a 2 level targeting error for intervention, and a 3 level error for charting. The reliability experiment showed examiners accurately maintained contact with the same thoracic spinous process as the participant went from upright to prone, ICC (2,1) = 0.83. Conclusions As manual therapists, the authors have emphasized how targeting errors may impact upon manual care of the spine. Practitioners in other fields that need to accurately locate spinal levels, such as acupuncture and anesthesiology, would also be expected to draw important conclusions from these findings.

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