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.

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.

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.

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).

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

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.

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

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).

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

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.

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

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
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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