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Manual Muscle Testing:
General Considerations
Manual Muscle Testing Precautions
The following are general guidelines to minimize risk of injury to the patient . Please
note that these guidelines are not comprehensive because covering all possible con-
ditions would be impossible . Therefore, final responsibility for the risk of injury to the
patient lies with the examiner .
1 . Force increase should be gradual .
2 . Patient should be CLOSELY observed for any evidence of pain . The test should be
stopped immediately if this occurs .
Manual Muscle Testing - General Information
Manual muscle testing or grading should be performed when neurological problems
at the nerve root or peripheral nerve are suspected, or if disease or disuse affects the
muscles . Manual muscle testing can help identify specific nerve motor function .
Bilateral testing indicating a weakness in several muscles may further substantiate
disease or injury involving nerve roots or peripheral nerves, as long as disuse or dis-
ease of the fibers of the muscle or disorders of the higher levels of the central ner-
vous system are ruled out .
Manual muscle testing should never be used alone to diagnose, but should be used in
conjunction with other diagnostic testing tools such as the Dualer dual inclinometry
system or Commander Algometer pain/pressure testing . If a rehabilitation program is
initiated, bilateral manual muscle testing should be completed at periodic intervals
along with other diagnostic testing to document treatment efficacy .
Manual Muscle Testing Accuracy
General rules must be followed to insure repeatability and accuracy when using the
Muscle Tester manual muscle tester .
1 . If testing bilaterally, the muscles and/or tendons that normally cause the motion
should be palpated bilaterally to help identify substitution by muscles other than
the prime movers . Adjust patient stabilization or position until substitution is
eliminated . If substitution continues, document the nature of the substitution .
2 . The lever arm length between the attachment point of the muscle and the
Muscle Tester dynamometer must be the same between repetitions and ses-
sions . Make sure the unit is placed at the same location for each repetition and
test . For multiple repetitions, better accuracy is achieved if the unit remains
placed on the body during all repetitions .
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