Muscle Strength Testing: Difference between revisions
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== Introduction<br> == | == Introduction<br> == | ||
An assessment of muscle strength is typically performed as part of a patient's objective assessment. This should assist the physiotherapist's clinical reasoning and enable them to reason an appropriate point to begin strengthening rehabilitation from. Muscle strength can be assessed by a number of methods: manually, functionally or mechanically (<ref name="Porter">Porter S. Tidy's Physiotherapy. Edinburgh: Churchill Livingstone, 2013.</ref>). | An assessment of muscle strength is typically performed as part of a patient's objective assessment. This should assist the physiotherapist's clinical reasoning and enable them to reason an appropriate point to begin strengthening rehabilitation from. Muscle strength can be assessed by a number of methods: manually, functionally or mechanically (<ref name="Porter">Porter S. Tidy's Physiotherapy. Edinburgh: Churchill Livingstone, 2013.</ref>). | ||
== The Oxford Scale == | == The Oxford Scale == | ||
The Oxford scale is commonly used by physiotherapists to manually assess muscle strength. According to the Oxford scale, muscle strength is graded 0 to 5. The grades are summarised below:<br> | The Oxford scale is commonly used by physiotherapists to manually assess muscle strength. According to the Oxford scale, muscle strength is graded 0 to 5. The grades are summarised below:<br> | ||
#Flicker of movement | #Flicker of movement | ||
#Through full range actively with gravity counterbalanced | #Through full range actively with gravity counterbalanced | ||
#Through full range actively against gravity | #Through full range actively against gravity | ||
#Through full range actively against some resistance | #Through full range actively against some resistance | ||
#Through full range actively against strong resistance | #Through full range actively against strong resistance | ||
There are a number of limitations to the usefulness of the Oxford | [http://www.biomedcentral.com/1746-1340/15/4 There are a number of limitations to the usefulness of the Oxford scal]e <ref name="Cuthbert and Goodheart">Cuthbert SC, Goodheart GJ. On the reliability and validity of manual muscle testing: a literature review. Chiropractic & Osteopathy 2007; 15:4</ref>. These include: | ||
*poor functional relevance; | *poor functional relevance; | ||
*non-linearity ( the difference between grades 3 and 4 is not necessarily the same as the difference between grades 4 and 5); | *non-linearity ( the difference between grades 3 and 4 is not necessarily the same as the difference between grades 4 and 5); | ||
*a patient's variability over time (for example, alternating between grades due to fatigue); | *a patient's variability over time (for example, alternating between grades due to fatigue); | ||
*intra-rater reliability | *intra-rater reliability | ||
*only assesses muscles when contracting concentrically | *only assesses muscles when contracting concentrically | ||
*the difficulty of applying the Oxford scale to all patient's in clincal practice (so that strength is rarely assessed throughout full range as many patients assessed by physiotherapists do not possess full range due to their repsecitve pathology. | *the difficulty of applying the Oxford scale to all patient's in clincal practice (so that strength is rarely assessed throughout full range as many patients assessed by physiotherapists do not possess full range due to their repsecitve pathology. | ||
Due to these shortcomings, physiotherapists commonly use modifed versions of the Oxford scale in clinical practice (<ref name="Porter" />). | Due to these shortcomings, physiotherapists commonly use modifed versions of the Oxford scale in clinical practice (<ref name="Porter" />). | ||
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | ||
<div class="researchbox"><rss>http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1NGmwZeh8Jw3IyqzgIIw1ePmXm0T83Jip7bkyU1YRNu5B_TslP|charset=UTF-8|short|max=10</rss></div> | <div class="researchbox"><rss>http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1NGmwZeh8Jw3IyqzgIIw1ePmXm0T83Jip7bkyU1YRNu5B_TslP|charset=UTF-8|short|max=10</rss></div> | ||
== References<br> == | |||
== References<br> == | |||
<references /> | <references /> | ||
[[Category:Open_Physio]] [[Category:Assessment]] | [[Category:Open_Physio]] [[Category:Assessment]] |
Revision as of 22:56, 29 August 2014
Original Editor - The Open Physio project.
Top Contributors - Admin, Pieter Jacobs, Kim Jackson, Lucinda hampton, Naomi O'Reilly, Lenie Jacobs, Jo Etherton, Claire Knott, Wanda van Niekerk, Alistair James, Vidya Acharya, Shaimaa Eldib, Rachael Lowe, WikiSysop, 127.0.0.1, Chrysolite Jyothi Kommu, Ammar Suhail and Kai A. Sigel
Introduction
[edit | edit source]
An assessment of muscle strength is typically performed as part of a patient's objective assessment. This should assist the physiotherapist's clinical reasoning and enable them to reason an appropriate point to begin strengthening rehabilitation from. Muscle strength can be assessed by a number of methods: manually, functionally or mechanically ([1]).
The Oxford Scale[edit | edit source]
The Oxford scale is commonly used by physiotherapists to manually assess muscle strength. According to the Oxford scale, muscle strength is graded 0 to 5. The grades are summarised below:
- Flicker of movement
- Through full range actively with gravity counterbalanced
- Through full range actively against gravity
- Through full range actively against some resistance
- Through full range actively against strong resistance
There are a number of limitations to the usefulness of the Oxford scale [2]. These include:
- poor functional relevance;
- non-linearity ( the difference between grades 3 and 4 is not necessarily the same as the difference between grades 4 and 5);
- a patient's variability over time (for example, alternating between grades due to fatigue);
- intra-rater reliability
- only assesses muscles when contracting concentrically
- the difficulty of applying the Oxford scale to all patient's in clincal practice (so that strength is rarely assessed throughout full range as many patients assessed by physiotherapists do not possess full range due to their repsecitve pathology.
Due to these shortcomings, physiotherapists commonly use modifed versions of the Oxford scale in clinical practice ([1]).