Manual muscle testing: does it meet the standards of an adequate screening test?

Clin Rehabil. 2005 Sep;19(6):662-7. doi: 10.1191/0269215505cr873oa.


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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Humans
  • Knee / physiopathology*
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Muscle, Skeletal / physiopathology*
  • Physical Examination / instrumentation
  • Physical Examination / methods*
  • Predictive Value of Tests
  • Sensitivity and Specificity