THE ABILITY OF MALE AND FEMALE CLINICIAN TO EFFECTIVELY TEST KNEE EXTENSION STRENGTH USING MANUAL MUSCLE TESTING

It has been suggested that the accuracy oi manual muscle testing is de pendent on examiner strength. Our purpose was to relate male and femal e clinicians' upper extremity strength to their ability to challenge t he quadriceps and detect weakness in patients using manual muscle test ing. Quadriceps muscles of seven men and 12 women with postpoliomyelit is were tested manually by a male and female clinician while forces we re recorded with a hand-held dynamometer. Patients' maximal isometric knee extension force was recorded with a lido dynamometer and clinicia ns' maximal vertical push force was recorded with the hand-held dynamo meter. Manual muscle testing forces, patient maximum quadriceps forces , and examiner push forces were compared with repeated measures analys is Bf variance. Female examiners' maximal vertical push force (235.7 /- 54.3 N) was not significantly different from either female or male patients' maximal quadriceps force (166.8 +/- 66.7 N and 341.6 +/- 123 .7 N) but was only 60% and 40% oi the isometric knee extension forces generated by a group oi normal women and men. Male examiners were sign ificantly stronger (357.0 +/- 93.4 N) than the female bill not the mal e patients and produced 90% and 60% of the normal isometric quadriceps forces for women and men. Examiners gave appropriate grades in 30 of 38 tests. Examiner strength limits detection oi moderate quadriceps we akness with manual resistance. Most of the muscle test grades, however , were appropriate, given the examiner's upper extremity strength. Cli nicians using manual muscle testing should determine their maximal ver tical push force and the extent of weakness they can detect.