Muscle Testing 2 PDF

Muscle testing 2 Grade scales MRC scale Oxford scale Kendall scale MRC scale Oxford scale Kendall scale  5 grade : normal muscle performance with maximum resistance full range ; not break , hold in position 4 grade : full range ,against gravity, moderate resistance , without break...

Muscle testing 2 Grade scales MRC scale Oxford scale Kendall scale MRC scale Oxford scale Kendall scale  5 grade : normal muscle performance with maximum resistance full range ; not break , hold in position 4 grade : full range ,against gravity, moderate resistance , without break , but when use maximum resist result in break 50% of motor neurons used 3 grade : complete full range against gravity , without resist , minor resist cause break , 15% of motor neuron used Functional requiring Not locked  2 grade : complete full ROM in position ,with minimize the force of gravity , Horizontal plane of motion 1 grade : muscle contraction detect by visually or by palpation in superficial muscle , no movement , in any position Passive move the part ask the pt. to hold , palpate the muscle Basic Patient position Joint position Check the available passive ROM Patient instructions Demonstrate the desired movement Check the muscle of normal side Always start with grade 3 against gravity Don’t change patient position repeatedly Application of resistance Slowly and gradually Increasing or decreasing manual resistance Position of resistance Exp ; Patient in prone position , resistance for hip extension at foot at knee ? Limitation Pain Swelling Spastic :UMN Restricted ROM Contraindication for muscle testing Cardio vascular disease , respiratory disease Brain injury , C P, spastic Dislocation , unhealed # Myositis ossifications Parkinson disease Pain Inflammation ( joint , muscle) Hemophilia osteoporosis precaution Do not harm , be gentle Respect the pain Examine for available ROM Patient comfort Extra care for resisted test Bone ankylosis Hematoma If patient taken drug muscle relaxation or analgesia Prolonged immobilized patient Abdominal surgery ( hernia) New united # Alternate techniques of assessing muscle strength Resisted isometric test Break test Make test Functional assessment Myometer dynometer  Resisted isometric When movement is contraindicated because of pain Break test Resistance applied at end of ROM Make test Resistance applied through out the ROM Isometric hold ( break test ) show the muscle to have higher grade than the make test