title: A comparison of manual and quantitative elbow strength testing.
abstract: OBJECTIVE
  The aim of this study was to compare the clinical ratings of elbow strength obtained by skilled clinicians with objective strength measurement obtained through quantitative testing.
  
  
  METHODS
  A retrospective comparison of subject clinical records with quantitative strength testing results in a motion analysis laboratory was conducted. A total of 110 individuals between the ages of 8 and 65 yrs with traumatic brachial plexus injuries were identified. Patients underwent manual muscle strength testing as assessed on the 5-point British Medical Research Council Scale (5/5, normal; 0/5, absent) and quantitative elbow flexion and extension strength measurements.
  
  
  RESULTS
  A total of 92 subjects had elbow flexion testing. Half of the subjects clinically assessed as having normal (5/5) elbow flexion strength on manual muscle testing exhibited less than 42% of their age-expected strength on quantitative testing. Eighty-four subjects had elbow extension strength testing. Similarly, half of those displaying normal elbow extension strength on manual muscle testing were found to have less than 62% of their age-expected values on quantitative testing. Significant differences between manual muscle testing and quantitative findings were not detected for the lesser (0-4) strength grades.
  
  
  CONCLUSIONS
  Manual muscle testing, even when performed by experienced clinicians, may be more misleading than expected for subjects graded as having normal (5/5) strength. Manual muscle testing estimates for the lesser strength grades (1-4/5) seem reasonably accurate.
authors.affiliation: From the Orthopedic Biomechanics/Motion Analysis Laboratory, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Leili
authors.initials: L
authors.lastname: Shahgholi
authors.forename: Keith A
authors.initials: KA
authors.lastname: Bengtson
authors.forename: Allen T
authors.initials: AT
authors.lastname: Bishop
authors.forename: Alexander Y
authors.initials: AY
authors.lastname: Shin
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Spinner
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Basford
authors.forename: Kenton R
authors.initials: KR
authors.lastname: Kaufman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020516:Brachial Plexus Neuropathies / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D002648:Child; D015331:Cohort Studies; D004551:Elbow Joint / Q000294:innervation / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018908:Muscle Weakness / Q000175:diagnosis* / Q000209:etiology; D010808:Physical Examination / Q000379:methods*; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular / Q000502:physiology*; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult