Introduction to Manual Muscle Testing and Rating Scale
* When performing muscle tests, be sure to evaluate for
asymmetry of the muscle groups (i.e. atrophy on one side and not the other) and
landmarks prior to testing.
Grading
Scale:
Rating muscle tests is a skill that takes a long time to learn and perform with reliability. It is important to learn how much resistance a “normal” muscle can tolerate to know when a muscle is not performing to its potential. All tests must be performed bilaterally and the unaffected side should be tested first. This is crucial because the tester can then get an accurate idea of how much resistance the unaffected side can tolerate and what would be considered normal for the patient.
The scale below is comprised of both subjective and objective factors. The subjective is the examiner knowing how much resistance to give and how much resistance the patient can tolerate. The objective factors include: if the patient can complete the available range of motion, move against gravity, and if he/she can hold this position. All of these factors make accuracy in rating a muscle test difficult, but with practice intra-tester error can be kept at a minimum.
Grade
5:
Patient can hold the position against maximum resistance and through
complete
range of motion.
Grade
4:
Patient can hold the position against strong to moderate resistance,
has full range of motion.
Grade
3:
Patient can tolerate no resistance but can perform the movement through
the
full range of motion.
Grade
2:
Patient has all or partial range of motion in the gravity eliminated
position.
Grade
1:
The muscle/muscles can be palpated while the patient is performing the
action
in the gravity eliminated position.