Grading of motor function in stroke patients

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Grading of motor function in stroke patients - July 1, 2000 7:17:00 AM

cheapo

Posts: 9
Joined: February 3, 2000
Status: offline

Hi all,
most of us know that the grading of muscle strenght using the MMT system is an invalid method to determine the status of stroke patients as the problem lies in the CNS and not a musculoskeletal problem. However, there seems to be no conclusive method to grade motor control... some have suggested using Strong, Moderate and Weak to represent motor control of the limbs and trunk but is there other valid and reliable tools to grade the motor function of stroke patients?

Post #: 1

Re: Grading of motor function in stroke patients - July 3, 2000 5:57:00 PM

Narimah Daud

Posts: 7
Joined: April 10, 2000
From: Kuala Lumpur , Malaysia
Status: offline

Hi! chepo,
I agree with you taht MMT is not really applicable for stroke patients, but we need a rough guide for our assessement of the motor control for these patient. I found out just a simple quick SLR and Upper limbs movements is a great help for my assesement
and then progression of the rehablitation programme besides functional activities .

(in reply to cheapo)

Post #: 2

Re: Grading of motor function in stroke patients - July 17, 2000 12:19:00 PM

David

Posts: 19
Joined: February 8, 2000
From: St. Augustine, FL....USA
Status: offline

I stress the need to assess isolated movement. If the patient can move full range against gravity without substitution, thyen I say manual muscle test from there. If they cannot, have them go gravity eliminated. If can go full range, then grade them a 2/5. If there are any abnormal synnergies, against gravity and/or gravity eliminated, then I ffel the best way is to document what you see:

i.e. patient has isolated shoulder flexion through 1/4 of the range (45 degrees) A flkexion synnergy involving shoulder, elbow and wrist/fingers is present through the remaining available motion of shoulder flexion.

(in reply to cheapo)

Post #: 3

Re: Grading of motor function in stroke patients - July 24, 2000 6:19:00 AM

JLowe

Posts: 2
Joined: February 9, 2000
From: St. Augustine, FL
Status: offline

Per this topic of measuring muscle strength in a patient with neurologic dysfunction I would like to ask the members if they are currently using dynamometer testing. This has been raised as one way to quantify strength even of a patient with neurologic dysfunction. Does anyone have references or specifics on how to accomplish this type of testing clinically? I have tried having the patient move to the best of their ability and measure an isometric contraction using hand held dynamomter.
However, I am still also using the "old way" where I quantify the amount of isolated movement possible through a specified range or describe the synergist movement seen through what range. This seems more descriptive but much more subjective.
What are most clinicians using to objectify strength of their stroke patient??

(in reply to cheapo)

Post #: 4