Friday, February 8, 2008

Strength Testing

Muscle strength is rated on a scale of 0/5 to 5/5:

  • 0/5: no contraction
  • 1/5: muscle flicker, but no movement
  • 2/5: movement through a full range of motion, but not against gravity (test the joint in its horizontal plane)
  • 3/5: movement through a full range of motion, but not against resistance by the examiner
  • 4/5: movement possible against some resistance by the examiner (sometimes this category is subdivided further into 4/5, 4/5, and 4+/5)
  • 5/5: normal strength
Upper extremity Motor Testing




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Abnormal Upper Extremity Motor Exam

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Detailed Hand Motor Testing





Action Muscles Nerves Nerve Roots
Finger extension Extensor digitorum, Extensor indicis, Extensor digiti minimi Radial nerve (posterior interosseous nerve) C7, C8
Thumb abduction in plane of palm Abductor pollicis longus Radial nerve (posterior interosseous nerve) C7, C8
Finger abduction Dorsal interossei, Abductor digiti minimi Ulnar nerve C8, T1
Finger and thumb adduction in plane of palm Adductor pollicis, Palmar interossei Ulnar nerve C8, T1
Thumb opposition Opponens pollicis Median nerve C8, T1
Thumb abduction perpendicular to plane of palm Abductor pollicis brevis Median nerve C8, T1
Flexion at distal interphalangeal joints digits 2, 3 Flexor digitorum profundus to digits 2, 3 Median nerve C7, C8
Flexion at distal interphalangeal joints digits 4, 5 Flexor digitorum profundus to digits 4, 5 Ulnar nerve C7, C8
Wrist flexion and hand abduction Flexor carpi radialis Median nerve C6, C7
Wrist flexion and hand adduction Flexor carpi ulnaris Ulnar nerve C7, C8, T1
Wrist extension and hand abduction Extensor carpi radialis Radial nerve C5, C6
Elbow flexion (with forearm supinated) Biceps, Brachialis Musculocutaneous nerve C5, C6
Elbow extension Triceps Radial nerve C6, C7, C8
Arm abduction at shoulder Deltoid Axillary nerve C5, C6

Lower Extremity Strength Testing

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Abnormal Lower Extremity Motor Exam

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Action Muscles Nerves Nerve Roots
Hip flexion Iliopsoas Femoral nerve, and L1-L3 nerve roots L1, L2, L3, L4
Knee extension Quadriceps Femoral nerve L2, L3, L4
Knee flexion Hamstrings (semitendinosus, semimembranosus, biceps femoris) Sciatic nerve L5, S1, S2
Leg abduction Gluteus medius, Gluteus minimus, Tensor fasciae latae Superior gluteal nerve L4, L5, S1
Leg adduction Obturator externus, Adductor longus, magnus, and brevis, Gracilis Obturator nerve L2, L3, L4
Toe dorsiflexion Extensor hallucis longus, Extensor digitorum longus Deep peroneal nerve L5, S1
Foot dorsiflexion Tibialis anterior Deep peroneal nerve L4, L5
Foot plantar flexion Triceps surae (gastrocnemius, soleus) Tibial nerve S1, S2
Foot eversion Peroneus longus, Peroneus brevis Superficial peroneal nerve L5, S1
Foot inversion Tibalis posterior Tibal nerve L4, L5


Global Strength Testing

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Abnormal Global Strength Testing

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