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Updated: Aug 15, 2026
Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients
Published on: April 12, 2011
Manual muscle testing: does it meet the standards of an adequate screening test?
1Department of Physical Therapy, School of Allied Health, University of Connecticut, U-2101, Storrs, CT 06269-2101, USA. richard.bohannon@uconn.edu
Objective:
To describe the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of manual muscle testing.
Design:
Secondary analysis of cross-sectional strength data.
Setting:
Acute rehabilitation unit.
Participants:
Convenience sample of 107 consecutive qualifying rehabilitation inpatients.
Intervention:
Not applicable.
Main Outcome Measures:
Knee extension forces measured by manual muscle testing and hand-held dynamometry.
Results:
The ability of manual muscle testing to detect 15, 20, 25 and 30% between-side differences and deficits in knee extension force was described. Although the specificity of manual muscle testing was acceptable (mostly > 80%), its sensitivity to differences between sides and to deficits relative to normal never exceeded 75%. Its diagnostic accuracy was never greater than 78%.
Conclusion:
The results of this study cast doubt on the suitability of manual muscle testing as a screening test for strength impairments.
