NAME: _______________________________________________

DATE: ____________________

TESTING AND GRADING MUSCLE STRENGTH STEPS 1. Explain to the client what you are going to do, why it is necessary and how the client can cooperate. 2. Wash hands and observe appropriate infection control procedures. 3. Provide for client privacy. 4. Inquire if the client has any history of the following: presence of muscle pain onset, location, character, aggravating and alleviating factors; any limitations to movement or inability to perform ADLS 5. Inspect muscles for size. Compare the muscles on one side of the body to the same muscle on the other side. For any discrepancies, measure the muscles with tape. 6. Inspect the muscles and tendons for contractures. 7. Inspect the muscles for fasciculations and tremors. Inspect any tremors of the hands and arms by having the client hold the arms out in front of the body. 8. Palpate muscles at rest to determine muscle tonicity. 9. Palpate the muscles while the client is active and passive for flaccidity, spasticity and smoothness of the movement. 10. Test the muscle strength a. Sternocleidomastoid: Client turns the head to one side against resistance of your hand. Repeat with the other side. b. Trapezius: Client shrugs the shoulders against the resistance of your hands. c. Deltoid: Client holds arm up and resists while you try to push it down. d. Biceps: Client fully extends each arm and tries to flex it while you attempt to hold arm in extension. e. Triceps: Client flexes each arm and then tries to extend it against your attempt to keep arm in flexion. f. Wrist and finger muscles: Client spreads the fingers and resists as you attempt to push the fingers together. g. Grip strength: Client grasps your index and middle fingers while you try to pull the fingers out. h. Hip muscles: Client is supine, both legs extended; client raises one leg at a time while you attempt to hold it down. i. Hip abduction: Client is supine, both legs extended. Place your hands on the lateral surface of each knee; client spreads the legs apart against your resistance. j. Hip adduction: Client is in the same position as for hip abduction. Place your hands between the knees; client brings the legs together against your resistance. k. Hamstrings: Client is supine, both knees bent. Client resists while you attempt to straighten legs. l. Quadriceps: Client is supine, knee partially extended; client resists while you attempt to flex the knee. m. Muscles of the ankles and feet: Client resists while you attempt to dorsiflex the foot and again resists while you attempt to flex the foot 11. Document findings in the client record. S U NP COMMENTS