1 . Patient moderately resists against the examiner . If any resistance occurs, then
the patient has enough strength to provide resistance against the muscle test-
ing dynamometer . If the patient is too weak to provide any resistance, grades
0/1, 2, or 3 should be assigned based on test results obtained without using
the dynamometer .
2 . Place the patient in the recommended position and conduct a test using the
dynamometer . Repeat for a minimum of three repetitions to ensure accuracy
and repeatability .
3 . Repeat the test for the opposite side .
4. If a strength deficit greater than 15% exists bilaterally when tested with the
dynamometer, the weaker side should be assigned a grade 4 . As noted earlier,
a grade is required if the test is to be included in an impairment report .
Grading may be skipped if all that is needed is the bilateral strength compari-
son for showing progress, justifying treatment, or determining the injured/dis-
eased nerves .
Grading without the Muscle Testing Dynamometer
If the subject does not have sufficient strength to resist against the force gauge or
a force gauge test is infeasible, then the following grading system can be used .
Grade 4/5 -
Good/Normal
: Moderate to full resistance against the examiner .
Grade 3 -
Fair
: Partial to complete motion against gravity .
Grade 2 -
Poor
: Partial to complete motion with gravity removed .
Grade 0/1-
Zero/Trace
: No contraction to slight contraction .
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