REHB1001 Chap.15 Muscle Length Testing and Manual Muscle Testing
Muscle Length Testing and Manual Muscle Testing
Practicals 7 to 10 complete the techniques for the second task on a skills card. This chapter reproduces the course's muscle grading table from 0 to 5, groups it into bands by gravity and resistance, and explains test positions, fixation, commands and the location and direction of force.
It then covers muscle length testing: fixing the origin, moving the insertion to the end of range, the Thomas test and straight leg raise, and the printed normal lengths, with a worked R.E.S.Q record. Practice items include grading from a description and writing a soleus length record, two tasks that appear on skills demonstration cards.
What this chapter covers
- 01
Manual muscle testing and dynamometry
- 02
The grading table from 0 to 5
- 03
Gravity eliminated versus against gravity
- 04
Commands by grade
- 05
Force location and direction
- 06
Muscle length testing principles
- 07
Thomas test and printed normals
Worked example · free
Grading a muscle from what the patient can do
- +1Holding the test position against gravity without resistance meets grade 3.
- +1Grade 4 needs a hold against gravity and therapist resistance: 4- slight, 4 moderate, 4+ moderate to strong.
- +1Giving way at moderate resistance suggests the hold met slight resistance only, so record 4- if slight resistance was held, otherwise 3.
Key terms
- Manual muscle testing
- Grading strength by hand against gravity and therapist resistance.
- Gravity eliminated
- A test position in the horizontal plane used for grades 0 to 2.
- Thomas test
- A supine position for testing the length of the hip flexors, tensor fascia lata, ITB and adductors.
- Fixation
- Stabilising one end of a muscle while the other end is moved or resisted.
- Straight leg raise
- A passive leg lift with the knee straight used to test hamstring length.
- Two-joint muscle
- A muscle crossing two joints, tested by holding one joint steady and moving the other.
- Substitution
- Use of other muscles or movements to complete a test, which must be recorded.
- Grade 3
- A muscle that holds the test position against gravity without added resistance.
Muscle Length Testing and Manual Muscle Testing FAQ
Why does the course start a muscle test at grade 3?
Practical 9 tells you to set the patient up for grade 3 first, testing whether they can move against gravity. If they can, add resistance to test grades 4 and 5; if they cannot, reposition in the horizontal plane with gravity eliminated to test grades 0 to 2.
Where should resistance be applied in a manual muscle test?
On the most distal stable surface away from the joint the muscle crosses, but proximal to the next joint, giving a long lever. Resistance opposes the muscle's line of pull and is built up gradually so the person has time to respond, which separates grades 4-, 4 and 4+.
Is there a normal angle for the hamstring length test?
Practical 8 does not give one. The straight leg raise is stopped when the knee begins to flex or the pelvis tilts, felt by a hand on the ASIS, which marks the end of hamstring range. Record the finding and compare it with the other side.
What should I consider before testing a muscle's length?
The manual lists four things: the origin and insertion, whether the muscle crosses one joint or several, its actions, because the test movement is their opposite, and the surface landmarks that show where it runs. Planning these first decides your starting position, which end to fix and which way to move the limb.
What does the Thomas test examine?
Practical 8 uses it for iliopsoas, rectus femoris, tensor fascia lata, the iliotibial band and the hip adductors. The patient flattens the lumbar spine by hugging the other knee, the tested leg hangs freely over the plinth, a hand on the ASIS monitors the pelvis, and a towel between the legs preserves dignity.
What are the commands for each band of muscle grades?
For grades 0 to 2, describe the movement, such as asking the person to straighten the knee on a count of three. For grade 3, ask them to hold the position. For grades 4 and 5, ask them to hold against you. Keep every command brief, clear, well projected and free of jargon.
Exam move
Learn the grading table exactly, then practise grading on a partner with each command spoken aloud. For each length test on the summary sheets, say the origin, insertion, action and the opposite movement before you touch the limb. Run timed practice cards that pair one length or strength test with documentation, and check every record against R.E.S.Q.
Learn the commands for each band of grades and say them aloud during every practice test until they are automatic.
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