Grade 1—Perceptible contraction in muscle, but no movement
Grade 2—Gravity-eliminated range of motion
Grade 3—Against gravity range of motion
Grade 4—Motion against resistance
Grade 5—Normal strength
Interpretation
The higher the number, the better the strength.
Clinical relevance
Detects functional weakness and assists in the identification of the neurological lesion based on specific muscle group weakness.
Reliability
Population tested in
Interobserver reliability
Intraobserver reliability
Not tested
Hand-held dynamometer
Description
A portable and objective tool to measure grip strength. Can be used bilaterally to compare relative strength differences.
Interpretation
The greater the value, the greater the strength.
Clinical relevance
Assessment of grip strength.
Reliability
Population tested in
Interobserver reliability
Intraobserver reliability
Spinal cord injury patients (N = 29) measured twice by four observers: two experienced physical therapists and two student physical therapists [1]
+
+
Children with spina bifida (N = 20) measured by three observers: two experienced physical therapists and one student physical therapist [2]
+
NA
Spinal cord injury patients (N = 25) measured twice on the same day by one observer [3]
NA
+
References:
1. Larson CA, Tezak WD, Malley MS, et al (2010) Assessment of postural muscle strength in sitting: reliability of measures obtained with hand-held dynamometry in individuals with spinal cord injury. J Neurol Phys Ther; 34:24–31.2. Mahony K, Hunt A, Daley D, et al (2009) Intertester reliability and precision of manual muscle testing and hand-held dynamometry in lower limb muscles of children with spina bifida. Phys Occup Ther Pediatr; 29:44–59.3. May LA, Burnham RS, Steadward RD (1997) Assessment of isokinetic and hand-held dynamometer measures of shoulder rotator strength among individuals with spinal cord injury. Arch Phys Med Rehabil; 78:251–255.
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