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Clinical Rehabilitation
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Manual muscle testing: does it meet the standards of an adequate screening test?

Richard W Bohannon

Department of Physical Therapy, School of Allied Health, University of Connecticut, Storrs, Connecticut, USA

Objective: To describe the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of manual muscle testing.

Design: Secondary analysis of cross-sectional strength data.

Setting: Acute rehabilitation unit.

Participants: Convenience sample of 107 consecutive qualifying rehabilitation inpatients.

Intervention: Not applicable.

Main outcome measures: Knee extension forces measured by manual muscle testing and hand-held dynamometry.

Results: The ability of manual muscle testing to detect 15, 20, 25 and 30% between-side differences and deficits in knee extension force was described. Although the specificity of manual muscle testing was acceptable (mostly>80%), its sensitivity to differences between sides and to deficits relative to normal never exceeded 75%. Its diagnostic accuracy was never greater than 78%.

Conclusion: The results of this study cast doubt on the suitability of manual muscle testing as a screening test for strength impairments.

Clinical Rehabilitation, Vol. 19, No. 6, 662-667 (2005)
DOI: 10.1191/0269215505cr873oa


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