What is wrong with manual muscle testing?

What is wrong with manual muscle testing?

What is wrong with manual muscle testing? Maybe nothing, maybe a lot. The great thing about being a clinician 10 years into your career is you can sit and reflect and really questions things like this.

I read an interesting blog article today by Chris Hart at MyRehabExpert.com regarding how manual muscle testing is ruining physical therapy as a field. While I feel there are many techniques that may be out dated, I don’t think we should throw the baby out with the bathwater on manual muscle testing just yet.

What does the research show?

Overall, manual muscle testing (MMT) couldn’t be shown to show a true muscle grade difference unless it was about 11-25% difference and could not detect side to side differences unless they were 15-25%. But I think it is important to keep in mind, MMT can show differences.

So what should we be using?

Isokinetic Dynamometry seems to be the gold standard, but those machines cost $15,000 easy, and are not in the majority of clinics because of that fact. The cost in addition to the size of the machine are two factors that if improved in the future (smaller and more cot effective) could be really beneficial.

Isokinetic Dynamometer
Isokinetic Dynamometer











But one relatively cheaper option clinicians may want to consider is the handheld dynamometer option At approximately $1000, this device may be a little more cost effective and may give a bit more objective data for clinicians to use.

Hand held dynamometer

Hand held dynamometer


Technology is a very cool aspect of healthcare…when it works. Technology is  growing and improving at a very vast rate which is great news for healthcare. We must remember, first and foremost, will the use of certain technologies benefit our patients? Next we must ask if the outcomes produced are worth the cost of the technology? I think it is best to default to the typical physical therapy answer here, “it depends”. One would have to do a cost benefit analysis of these questions to decide if the technology is a good fit for their situation.


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