Manual Muscle Testing

Overview

Is a way to assess muscle strength relating to either:
- Generalized weakness
- Localized weakness
- Neurological deficits
Involves applying resistance as a patient performs a movement and subjectively grading their strength on a scale from 0 to 5

Manual Muscle Testing Scores

0: No muscle activation
1: Trace muscle activation (like a twitch) without achieving full range of motion of the movement
2: Muscle activation in gravity eliminated position with a full range of motion achieved
3-: Able to achieve partial range of motion against gravity (no resistance)
3: Able to achieve full range of motion against gravity (no resistance)
3+: Able to hold test position against slight pressure
4-: Able to hold test position against slight to moderate pressure
4: Able to hold test position against slight to moderate pressure
4+: Able to hold test position against moderate to strong pressure
5: Able to hold test position against strong pressure

Technique

Position the patient in an optimal way for muscles being tested
- For the upper extremity, the patient can typically sit in a chair for all muscles (unless a patient needs to move to a table to do the test in a gravity eliminated position if they have severe weakness
Apply resistance just proximal to the joint being tested (upper part of humerus when testing shoulder, upper part of forearm when testing elbow)
Assess patient's strength based on scale above

Contraindications