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David -> Re: Grading of motor function in stroke patients (July 17, 2000 12:19:00 PM)
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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.
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