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. 1983 Nov;46(11):1006–1013. doi: 10.1136/jnnp.46.11.1006

The measurement of muscle strength in patients with peripheral neuromuscular disorders.

C M Wiles, Y Karni
PMCID: PMC491736  PMID: 6655475

Abstract

The variability of voluntary isometric strength measurements has been assessed in normal subjects and patients with peripheral neuromuscular disorders. Knee extensor strength was measured in a muscle testing chair 13 times over 5 months in each of six normal subjects: coefficients of variation (CV) ranged from 4.5 to 14.0% (mean 8.5%) for individual legs in different subjects. Paired measurements of the strength of several clinically weak muscle groups were made 1-4 days apart in 20 patients using both a handheld dynamometer and the muscle chair technique: the test/retest correlation was high (r = 0.97, p less than 0.001). Visual biofeedback did not affect the strength recorded in most cases. Each of five patients had the strength of six or seven clinically weak muscle groups measured by five examiners within a 24 hour period: the CV for the five examiners ranged from 3.6-27.3% (mean 12.8%). A single examiner measuring the same groups on five occasions in three patients obtained a mean CV of 8.9%. Sources of variation are analysed and it is concluded that, with certain precautions, voluntary strength measurements offer a simple, reliable and acceptable method for monitoring change in patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BARWICK D. D., NEWELL D. J., WALTON J. N. Methandrostenolone and nandrolone decanoate in muscular dystrophy; a controlled trial. Neurology. 1963 Jan;13:12–23. doi: 10.1212/wnl.13.1.12. [DOI] [PubMed] [Google Scholar]
  2. Dinsdale S. M., Cole T. M., Zaki F. G., Awad E. A. Measurements of disease activity in dermatomyositis. Arch Phys Med Rehabil. 1971 May;52(5):201–passim. [PubMed] [Google Scholar]
  3. Edwards R. H., Hyde S. Methods of measuring muscle strength and fatigue. Physiotherapy. 1977 Feb;63(2):51–55. [PubMed] [Google Scholar]
  4. Edwards R. H., McDonnell M. Hand-held dynamometer for evaluating voluntary-muscle function. Lancet. 1974 Sep 28;2(7883):757–758. doi: 10.1016/s0140-6736(74)90947-7. [DOI] [PubMed] [Google Scholar]
  5. Edwards R. H., Wiles C. M., Round J. M., Jackson M. J., Young A. Muscle breakdown and repair in polymyositis: a case study. Muscle Nerve. 1979 May-Jun;2(3):223–228. doi: 10.1002/mus.880020311. [DOI] [PubMed] [Google Scholar]
  6. Edwards R. H., Young A., Hosking G. P., Jones D. A. Human skeletal muscle function: description of tests and normal values. Clin Sci Mol Med. 1977 Mar;52(3):283–290. doi: 10.1042/cs0520283. [DOI] [PubMed] [Google Scholar]
  7. Fowler W. M., Jr, Gardner G. W. Quantitative strength measurements in muscular dystrophy. Arch Phys Med Rehabil. 1967 Dec;48(12):629–644. [PubMed] [Google Scholar]
  8. Friman G. Effect of acute infectious disease on isometric muscle strength. Scand J Clin Lab Invest. 1977 Jun;37(4):303–308. doi: 10.3109/00365517709092633. [DOI] [PubMed] [Google Scholar]
  9. Hosking J. P., Bhat U. S., Dubowitz V., Edwards R. H. Measurements of muscle strength and performance in children with normal and diseased muscle. Arch Dis Child. 1976 Dec;51(12):957–963. doi: 10.1136/adc.51.12.957. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Osterman P. O., Fagius J., Säfwenberg J., Danersund A., Wallin B. G., Nordesjö L. O. Treatment of the Guillain-Barré syndrome by plasmapheresis. Arch Neurol. 1982 Mar;39(3):148–154. doi: 10.1001/archneur.1982.00510150018005. [DOI] [PubMed] [Google Scholar]
  11. Peacock B., Westers T., Walsh S., Nicholson K. Feedback and maximum voluntary contraction. Ergonomics. 1981 Mar;24(3):223–228. doi: 10.1080/00140138108559236. [DOI] [PubMed] [Google Scholar]
  12. Persson L. I., Rosengren L. E. Kinetics of blood-brain barrier dysfunction to albumin around small cerebral stab wounds. Acta Neurol Scand. 1982 Jan;65(1):1–5. doi: 10.1111/j.1600-0404.1982.tb03054.x. [DOI] [PubMed] [Google Scholar]
  13. RUSSELL W. R., FISCHER-WILLIAMS M. Recovery of muscular strength after poliomyelitis. Lancet. 1954 Feb 13;266(6807):330–333. doi: 10.1016/s0140-6736(54)91084-3. [DOI] [PubMed] [Google Scholar]
  14. Resnick J. S., Mammel M., Mundale M. O., Kottke F. J. Muscular strength as an index of response to therapy in childhood dermatomyositis. Arch Phys Med Rehabil. 1981 Jan;62(1):12–19. [PubMed] [Google Scholar]
  15. Scott O. M., Hyde S. A., Goddard C., Dubowitz V. Quantitation of muscle function in children: a prospective study in Duchenne muscular dystrophy. Muscle Nerve. 1982 Apr;5(4):291–301. doi: 10.1002/mus.880050405. [DOI] [PubMed] [Google Scholar]
  16. TOURTELLOTTE W. W., HAERER A. F., SIMPSON J. F., KUZMA J. W., SIKORSKI J. QUANTITATIVE CLINICAL NEUROLOGICAL TESTING. I. A STUDY OF A BATTERY OF TESTS DESIGNED TO EVALUATE IN PART THE NEUROLOGICAL FUNCTION OF PATIENTS WITH MULTIPLE SCLEROSIS AND ITS USE IN A THERAPEUTIC TRIAL. Ann N Y Acad Sci. 1965 Mar 31;122:480–505. doi: 10.1111/j.1749-6632.1965.tb20231.x. [DOI] [PubMed] [Google Scholar]
  17. Wiles C. M., Jones D. A., Edwards R. H. Fatigue in human metabolic myopathy. Ciba Found Symp. 1981;82:264–282. doi: 10.1002/9780470715420.ch16. [DOI] [PubMed] [Google Scholar]
  18. Wiles C. M., Young A., Jones D. A., Edwards R. H. Muscle relaxation rate, fibre-type composition and energy turnover in hyper- and hypo-thyroid patients. Clin Sci (Lond) 1979 Oct;57(4):375–384. doi: 10.1042/cs0570375. [DOI] [PubMed] [Google Scholar]
  19. Ziter F. A., Allsop K. G., Tyler F. H. Assessment of muscle strength in Duchenne muscular dystrophy. Neurology. 1977 Oct;27(10):981–984. doi: 10.1212/wnl.27.10.981. [DOI] [PubMed] [Google Scholar]
  20. de Lateur B. J., Giaconi R. M. Effect on maximal strength of submaximal exercise in Duchenne muscular dystrophy. Am J Phys Med. 1979 Feb;58(1):26–36. [PubMed] [Google Scholar]

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