Intraexaminer comparison of applied kinesiology manual muscle testing of varying durations: a pilot study

Abstract

Objective: The purpose of this study is to investigate the difference in results (strong/facilitated vs weak/functionally inhibited) between short (1 second) and long (3 seconds) manual muscle tests (MMTs) on the same subject and to pilot the use of thin-film force transducers for characterizing the parameters of MMT and for measuring maximum voluntary isometric contraction (MVIC). Method: Forty-four healthy chiropractic students were tested. A thin-film force transducer recorded force over time during MVIC of the middle deltoid and 1-and 3-second MMTs of the same subjects. The MMTs were graded as strong (able to resist the testing pressure) or weak (unable to resist testing pressure, breaking away). Results: Forty-two short tests were strong, and 2 were weak. Thirty-nine long tests were strong, and 5 were weak. κ (0.54) showed fair agreement for results between short and long tests. Peak force in both short and long weak tests was higher than that in strong tests when expressed as a proportion of maximum contraction. All manual tests used less force than MVICs. Conclusions: This study demonstrated that a study of this nature is feasible. Longer test durations demonstrate some muscle weaknesses that are not evident on 1-second MMTs. Thin-film transducers show promise for recording MMT parameters for research purposes.

A narrative review of manual muscle testing and implications for muscle testing research

“…In our study comparing peak force during MVICs and 1-second and 3-second MMTs of the middle deltoid, 22,23 although there were few weak muscles in the 42 subjects tested, 3 subjects had weakness on the long tests that was not evident on the short tests. Short and long MMTs do sometimes yield different results, supporting the hypothesis that the differences observed by Schmitt between "patient-started" and "examinerstarted" tests may be differences in duration of tests.…”

“…In our study 22,23 of muscle tests of different durations, even subjects whose muscles manually tested weak were able to maintain MVIC contractions for 5 to 10 seconds until told they could stop. Taking this and the data of Leisman et al into account, it is highly unlikely that muscle fatigue is what is being measured in a manual test.…”

“…Test stopped when "lock" perceived by tester. AK "G2" or "patient-started test" 16,24,25,[17][18][19]22,23 Make test, with late added pressure 2.5-3.5 s Facilitated/strong (grade 5) vs inhibited/weak (grades 0-4) Tester acts as "fixed" resistance to a perceived maximum then adds pressure to attempt to break. May require tester to be stronger than subject.…”

“…[17][18][19][20][21][22][23][24][25]38 The manual test was able to distinguish a difference in muscle function between strong and weak muscles rapidly and accurately, without taking the muscle to the point of fatigue. Electrophysiological differences in muscle state were evident at a broad range of force and duration levels.…”

Defining the rehabilitation treatment programs for stroke patients by applying Neural Network and Decision Trees models

“…For example, Modified Ashworth Scale (MAS) is applied to patients if therapists need to investigate the severity of spasticity [5]. Similarly, if the therapists need to evaluate the strengthening of muscle, the manual muscle testing (MMT) is performed [6]. Moreover, there are some specific assessments that are applied to the patients for evaluating the sensation, balance control [7], reflex and functional independence during mobility or activities daily living [8].…”