WRIST STRENGTH MEASURED BY MYOMETRY AS AN INDICATOR OF FUNCTIONAL INDEPENDENCE

The purpose of this study was to show that independence of self care a ctivities of motor complete quadriplegic patients related better to th e force of contraction of the wrist extensor (WE) muscles measured by a hand held myometer than to the manual muscle test (MMT) for grades 3 to 5. The patients (n = 24), identified by having unilaterally or bil aterally functional WE muscle (MMT greater than or equal to 3/5) with bilateral elbow extensor (EE) muscles <3/5, were evaluated at 2 to 6 m onths after injury for four feeding activities utilizing the Quadriple gia Index of Function (QIF). We found 54% were independent drinking fr om a cup, 58% using a spoon or fork, 13% cutting food, and 23% pouring liquids. Comparisons were made between right, left, and bilateral mea n myometry scores and median MMT scores for each of the QIF activities . The independent group of patients had myometry scores 54 to 140% gre ater (p < 0.05) than those patients dependent in the self care activit y except when the right or left WE myometric score was analyzed for cu tting food (p = 0.1). MMT comparisons showed no significant median sco re differences in any activity performed. There were no patients with only one WE muscle greater than or equal to 3/5 (n = 9) who were able to cut food or pour liquids independently. In conclusion, myometry app eared to be a better indicator than the MMT for some self care activit ies evaluated utilizing the Quadriplegia Index of Function.