Objective - Muscle Testing

Question 1

Muscle tests

Answer 1

1. Resisted Isometric muscle testing
2. Muscle strength tests (Oxford grading/MRC) - through full available range (whether isometric, concentric, eccentric or to fatigue)
3. Muscle length tests
4. Palpation - looking for site of lesion

+ Muscle bulk tests to quantify atrophy/hypertrophy (difficult to measure in same place each time)
+ Diagnostic muscle tests
+ Muscle control tests - functional movements

Question 2

Resisted isometric muscle testing

Answer 2

> testing contractile tissues - however can cause pain due to compression at joint so may not always mean muscle injury
joint in relaxed position to isolate single muscle
Looking at reproducing symptoms ie. pain or weakness (+look at quality of movement - shaking etc.)

Possible findings
> Strong + painless = normal
> Strong + painful - may indicate tendinopathy or minor muscle injury
> Weak + painful - fracture/ incomplete rupture/ tendon disorder
> Weak + painless - muscle rupture (nerve = ruptured as well)
> Painful on repetition - vascular disorder - intermittent claudication due to build up of lactic acid
> All movements = painful - affective disorder such as biopsychosocial elements (look at fear elements)/ neuro disorder

Question 3

Oxford Strength testing

Answer 3

> Tested manually usually in concentric contraction - THROUGH FULL RANGE 
> Oxford scale: 
0 = no muscle movement
1 = flicker 
2 = contraction with gravity removed 
3 = vs. gravity
4 = minimal resistance
5 = heavy resistance
*if bilateral can look at normative data 

Also consider that if the muscle length is altered the production of force will be maximal at different stages due to altered length-tension curve (shortened = stronger earlier and lengthened = later)
- Normal length - max force = mid range

Question 4

Muscle length testing

Answer 4

> Some muscles can become tight and lose extensibility
When testing note - quality of movement
(vs unaffected side) - range of movement
- resistance vs pain (what’s the bigger limiting factor)
*Can look at end feel + other symptoms if done passively)
* Thomas test is good to look at tight anterior/medial hips + quadriceps

Question 5

Palpation

Answer 5

> Looking for lesion