Abstract: BACKGROUND AND PURPOSE: Manual muscle testing is the most commonly used procedure to assess patient strength. The purpose of this study was to determine the consistency in which physical therapists assign manual muscle testing grades. SUBJECTS: The subjects were 38 volunteer physical therapists from various clinical settings. All subjects had at least two years of clinical experience. METHODS AND MATERIALS: Subjects were instructed to apply either minimum, moderate, or maximum pressure which corresponded to assigning a grade of fair plus, good, or normal according to the Kendall system, respectively. The pressure was applied through the Nicholas Manual Muscle Tester to the right hip flexor muscle group of the researcher. A retest was performed approximately two weeks following the initial test. STATISTICAL ANALYSES: The absolute value of the difference between the initial test and retest was used to compare consistency of each subject. Paired samples t-tests were used to test for differences from the initial test to retest for each force level. A 2 X 3 repeated measures analysis of variance (ANOVA) was used to compare force means among force levels and between test days. The standard error of the measure (SEM) was calculated to estimate the precision of measurement made by examiners at each force level and test day. RESULTS: No significant difference was found between the initial test and retest for any of the force levels. Inconsistencies were found between the initial test and retest for each subject at each force level. Inconsistencies in the amount of applied pressure were found between subjects at each force level. Subjects were found to be the most inconsistent when applying maximum pressure. CONCLUSION: Clinicians were unable to reproduce the same force from initial test to retest. Clinicians also varied in the amount of pressure they perceived as minimum, moderate, and maximum. RELEVANCE: Inconsistencies in assigning grades exist; therefore, manual muscle testing may not be the most clinically useful measurement of strength.The pressure was applied through the Nicholas Manual Muscle Tester to the right hip flexor muscle group of the researcher. A retest was performed approximately two weeks following the initial test.
|Title||:||Examiner Consistency of Assigning Manual Muscle Testing Grades|
|Author||:||Michelle Menard, Gretchen Peterson, Elizabeth Spadafora, Kerry Spinale|