JTECH Medical Commander MN084 User manual

© 2016 JTECH Medical MN084_D
Muscle Tester

© 2016 JTECH Medical MN084_D
User’s Manual
Written by
Tracy Livingston, David Bernardi, and Michael Carroll
Published by
JTECH Medical
7633 S Main St.
Midvale, UT 84047
United States of America
[phone]
[phone]
www.jtechmedical.com
Authorized Representative for EU
Atlanco Systems
34 Oldeld, Kingston, Galway, Republic of Ireland
Company number: 443142
Email: Info@AtlancoSystems.com
Phone: [phone]
Muscle Tester

Contents
Graphic Symbol Definitions ...........................................1
Commander Warranty ...............................................1
To have your Commander or Muscle Tester repaired ......................1
Intended Use and Indications for Use ..................................2
Features and Benefits................................................2
Check Your System ..................................................3
Proper Care ........................................................3
Calibration .........................................................3
Battery Life ........................................................3
Available Upgrades..................................................4
Wrist and Desktop Use of the Console..................................4
Using the Commander Console
Conventions .......................................................5
On/Off Button......................................................5
Setup Mode .......................................................6
Test and Test Alt Modes .............................................7
Testing Methods ....................................................8
Advanced Console Features .........................................10
Reviewing an Exam.................................................10
Statistics Definitions................................................12
Deleting an Exam ..................................................12
Reports ..........................................................12
The Muscle Tester Dynamometer
Care and Cleaning..................................................13
Changing Testing Pads ..............................................13
Using the Dynamometer ............................................13
Manual Muscle Testing: General Considerations
Manual Muscle Testing Precautions ...................................14
Manual Muscle Testing - General Information...........................14
Manual Muscle Testing Accuracy .....................................14
Grading Muscle Tests
When Should a Muscle Test Be Graded? ...............................15
Grading with the Muscle Testing Dynamometer .........................15
Grading without the Muscle Testing Dynamometer ......................16

Commander Warranty
One-year Limited Warranty
The Commander™console and Muscle Tester dynamometer are designed to perform
reliably and to meet specifications. In spite of diligence in manufacturing, eliminating
malfunctions resulting from random component failure is impossible. Therefore, JTECH will
at its option repair or replace the product with a new or reconditioned unit at no charge for
a period of one year from the date of purchase.
In view of the varied conditions in which the unit will be used, the Commander Console and
Muscle Tester are sold “as is” and JTECH’s responsibility does not go beyond the terms set
forth above. JTECH will not be responsible for medical expenses or any direct, indirect, or
consequential damages arising from the use of this product. JTECH shall in no way be liable
loss of revenue or profits resulting or alleged to result from use of this product.
THIS WARRANTY IS MADE EXPRESSLY IN LIEU OF ANY OTHER WARRANTY, EXPRESS OR
IMPLIED, INCLUDING AN IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A
PARTICULAR PURPOSE. UNDER NO CIRCUMSTANCES SHALL JTECH BE LIABLE FOR ANY
DIRECT, INDIRECT, INCIDENTAL, OR CONSEQUENTIAL DAMAGES. THE REMEDIES SET FORTH
IN THIS WARRANTY SHALL BE THE ONLY REMEDIES AVAILABLE, EXCEPT AS SPECIFICALLY
PROVIDED BY STATE LAW. NO PERSON HAS ANY AUTHORITY TO BIND JTECH TO ANY
REPRESENTATION OR WARRANTY EXCEPT AS SPECIFICALLY SET FORTH HEREIN.
To have your Commander or Muscle Tester repaired:
1. Contact JTECH Customer Service and describe the problem. After receiving a
return authorization number, return the product to JTECH, including all
accessories, postage paid and insured to JTECH. JTECH is not responsible for
damages or losses incurred in shipping.
2. Submit proof of purchase and date.
3. Include a brief explanation describing the problem.
Graphic Symbol Denions
Symbol Meaning
An ISO 7010-M002 symbol Consult Instrucons
Informaon symbol
An IEC 60878-0434 symbol Cauon
“Conformité Européenne”
(“European Conformity”)
Soware products meet the provisions of the Council
Direcve 93/42/EEC
An EN 980 symbol Idenfying the Manufacturer
An EN 980 symbol Idenfying the Authorized Representave for
European Communies
1

Intended Use and Indications for Use
The intended use of the Commander Muscle Tester is to assist clinicians in obtaining patient
information regarding physical strength. The devices are intended to be used as non-inva-
sive, non-surgical and transient devices
Features and Benefits
Muscle Tester Dynamometer:
• Produces very stable make or break tests.
• Reduces “roll-over” and tilting with a 1.8” high ergonomic design that fits in
the palm.
• Uses snap-in-place Quick ConnectTM system for changing accessory pads, which
is much faster than old-fashion screw-on methods.
• Maintains accuracy even when force is applied off center with exclusive
Axis CompensationTM “smart” load cell.
• Guarantees 99% force accuracy over the entire test pad area, compared to
other products with off-center force accuracy from 94-96%. Call JTECH for
accuracy report details.
• Includes both round and curved test pads.
Commander™Console:
• Easy-to-read 2” diagonal LCD.
• Operates during exams either as a wrist unit or as a desktop system when
using the included longer cable.
• Gathers, stores, and analyzes up to 40 bilateral muscle strength tests, including
up to four repetitions per side.
• Calculates CV and maximum force for each repetition.
• Documents outcomes assessment with the automatic bilateral deficit analysis.
• Helps determine consistency of effort in workers compensation and FCE
exams.
• Test now, record later because the exam is stored in memory, even when
Commander is turned off.
• Automatic audio prompts examiner for the next test in the series.
• Measures up to 125 pounds for very strong performers.
• Battery powered for portable operation.
• Test protocols can be customized according to number of tests, starting force,
newtons/pounds and number of repetitions.
2

Check Your System
Your Muscle Tester Commander system should include the following parts:
• Commander Wrist Unit • Round Pad
• Muscle Tester Dynamometer • Curved Pad
• Short Cord • Testing Chart
• Long Cord • Worksheets
Make sure the serial number on the Muscle Tester, located under the testing pad,
matches the serial number on the Commander Console. If these numbers do not
match, call JTECH Customer Service.
Proper Care
With proper care your new Muscle Tester Commander will provide many years of
worry free use. Do not immerse the dynamometer or the console in water, place in
an autoclave or sterilize with harsh disinfectant. To clean the housings, wipe with a
soft, dry towel. To clean the display, use a non-abrasive dry cloth. Do not use
cleaners. Avoid dropping or banging the instrument or console against hard
objects. Do not stand on, apply more than 125 lb. or use the dynamometer for
anything other than manual muscle testing. Failure to follow these policies will
void the warranty.
Calibration
To ensure accuracy the Muscle Tester and Commander console have been factory
calibrated with weights traceable to the National Institute of Standards and
Technology. When turned on the Commander console automatically zero calibrates
itself. Therefore, make sure the dynamometer test pad is turned up and no force is
being applied when the Commander console is turned on. Any force applied to the
dynamometer when the console is turned on will become the zero value and will
result in inaccurate force readings.
Battery Life
The Commander console uses a standard 9 volt alkaline battery. The estimated
battery life is 28 hours of operation. The Commander console should always be
turned off when not in use to maximize battery life. (The console will automatically
shut itself off after four minutes of inactivity.) NiCad batteries can be used,
however, the active battery life will be reduced to approximately eight hours or
less. When using a NiCad battery, completely drain the battery before recharging
to prevent “memory” in the battery that will further reduce battery life.
3

Available Upgrades
The Muscle Tester can be used with the following upgrade products:
Commander Downloader™ - Transfer Commander test data easily to virtually any
word processor, exam form or spreadsheet with Commander Download Software
This Windows™ based package includes software and serial cable for transferring
test data. The software will automatically download all repetition and statistical
information and the titles of each test.
EasyDocs Software - Enter Commander test data on your PC with this keyboard
entry software. EasyDocs Software maintains your test data, along with additional
patient data, test data from other devices (such as inclinometers, goniometers, and
static lift gauges) and results from your favorite questionnaires. With Easy Docs you
can quickly and easily create cutting edge data and narrative reports. With the
optional EasyDocs Impairment Module, the system automatically calculates motor
deficit impairments from muscle testing results.
For more information on upgrades, contact your JTECH sales representative or call
JTECH at 1-800-985-8324 or 1-385-695-5000.
Wrist and Desktop Use of the Console
The Muscle Tester Commander system comes equipped with two cords for con-
necting the dynamometer to the console unit. The short cord is used when the
Commander console is strapped to the examiner’s forearm. The longer cord is used
when the Commander console is placed on a desktop or left in the case during
testing.
The cords connect to the console and dynamometer with telephone-jack plugs. To
remove a cord, press down on the cord-jack’s plastic release lever and slide the
end out of the receptacle. When installing a cord, make sure the jack “snaps”
securely into place.
NOTE: If a cord is damaged or lost, do not attempt to replace with a standard
telephone cord as the wiring is not the same. Contact JTECH Customer Service for
the correct replacement cord.
4

Using the Commander Console
Conventions
This manual adopts the following convention throughout:
Test Refers to one strength assessment that may include multiple repetitions
and comparisons between the right and left side. For instance, testing
elbow flexion with three repetitions for the right side and three repeti-
tions for the left side is one test.
Exam Refers to multiple tests. For example, testing elbow flexion, elbow exten-
sion, wrist flexion, and wrist extension could comprise one exam.
On/Off Button
Press the “ON/OFF” button once to turn the console on, press it again to
turn the console off. Exams stored in memory are not erased when power
is turned off. Holding the “ON/OFF” button down for two seconds clears
all stored exams. The console shuts off automatically after four minutes of
inactivity.
Note: Make sure no force is applied to the dynamometer when turning the console on.
When the console unit is turned on it will activate in either “Test” mode or
“Review” mode, depending on whether an exam is stored in memory. If no exam is
stored in memory the console will activate in Test mode ready for test #1.
ON/OFF
The active “mode,” in this case “TEST,” is displayed in this area.
Test and repetition numbers
are shown here.
Side being tested is displayed on
this line.
Real-time force on dynamometer
can be shown in pounds or new-
tons.
Testing Mode
5

If an exam is in memory when the console is turned on, Commander activates in
“Review” mode. From this point you can review exam data, change to “Test” mode
to finish testing, or delete the exam.
Setup Mode
Testing Defaults
The Commander console enables you to use the “Setup” mode to control a variety
of test parameters, such as the testing threshold, number of tests, number of repe-
titions per test, and force readings in pounds or newtons. Once test parameters are
set, they become the defaults for the console. For example, if you set the number of
repetitions to three, then the unit will test for three repetitions per side for every
exam, unless you change the default. Default settings do not change when the unit
is turned off or when an exam is deleted. Defaults can only be reset manually.
Setting Defaults
Three buttons are used when setting console defaults: TEST CONT. (SETUP), NEXT
(SELECT) and REVIEW (CHANGE). The buttons function as follows:
TEST CONT. (SETUP): Press this button to move through the console modes until
“Setup” is displayed. It is also used to exit “Setup” after setting parameters.
NEXT (SELECT): Use this button to advance through the test parameters.
REVIEW (CHANGE): This button changes the parameter setting.
Press this button until console
is in “Setup” mode. After
parameters are set, use this
button to exit back to “Test”
mode.
While in “Setup” mode, use
this button to advance through
parameters.
When a parameter is displayed,
use this button to change the
default setting.
6

Adjustable Defaults
The Muscle Tester Commander console allows you to control the following default
parameters:
THRESHOLD: This setting determines the amount of force that must be exerted
against the dynamometer before the console begins recording data. This setting is
used to avoid inadvertently beginning a test. It can be set at 1, 3, 5, 10 or 20
pounds.
TEST: Controls the number of tests available for an exam. The console automatical-
ly goes into “Review” mode when the number is reached. It can be set from 5-40
in increments of five.
REP: Sets the number of repetitions per side per test. It can be set from 1-4. A
minimum of two repetitions is required for CV calculations.
LBS (N): This parameter controls whether force readings are in pounds or newtons.
Test and Test Alt Modes
Tests are conducted using either the “Test” or “Test Alt” modes. (How the modes
are used is described below.)
To conduct a test, apply pressure on the dynamometer. Test recording begins
when the default threshold force is exceeded. A test ends when force on the
dynamometer drops back below the threshold. The display then indexes to the
next repetition in the series. After all repetitions for a test are completed, the dis-
play indexes to the next sequential test number. Continue testing with this method
until all tests are recorded in memory.
Repetitions for a Test
The Commander console can record up to four strength repetitions per side for
each test. The repetition order is selected by either of two methods:
Same Side Repetition Order: When “Test” mode is displayed, the unit prompts for
all right side repetitions first, then all left side repetitions.
For example, if the default is two repetitions, the test sequence in “Test” mode is:
TEST 1 REP 1 RIGHT
TEST 1 REP 2 RIGHT
TEST 1 REP 1 LEFT
TEST 1 REP 2 LEFT
TEST 2 REP 1 RIGHT
TEST 2 REP 2 RIGHT ....etc.
Helpful Hint: If unilateral testing is required, the right side can be tested and the
left side skipped by pressing the “NEXT” button, or the right side can be skipped by
pressing “NEXT” and testing the left side.
7

Alternating Sides Repetition Order: When “Test Alt” mode is displayed, the repeti-
tions alternate between right and left side as follows:
TEST 1 REP 1 RIGHT
TEST 1 REP 1 LEFT
TEST 1 REP 2 RIGHT
TEST 1 REP 2 LEFT
TEST 2 REP 1 RIGHT
TEST 2 REP 1 LEFT ....etc.
This method can be used if submaximal effort is indicated. By mixing up the left
and right side routine, the subject may have a more difficult time repeating the
results on each side as indicated by the coefficient of variation.
Testing Methods
The Commander console can store up to 40 tests in memory complete with data
for all repetitions and statistics. In order to easily record multiple tests the
Commander uses Automatic Indexing™. This method automatically indexes the dis-
play to the next test in the series without requiring you to press any buttons. For
example, after completion of all right and left side repetitions of test 1, the display
indexes to TEST 2 REP 1 RIGHT.
NOTE: After completing a test, Commander prevents inadvertent deletion of tests
previously stored in memory by indexing to the next test not completed. For
example, if test 2 was completed previously, after test 1 is completed Commander
will skip test 2 and index to test 3.
Sequential Testing Method
This method always begins with test 1 using Automatic Indexing™ to proceed from
test 1 to test 2, etc. Mark the muscle groups on the exam worksheet with the cor-
responding test numbers from the display.
For example, a muscle testing exam is com-
pleted in the following order: elbow flexion,
elbow extension and shoulder abduction.
Before starting the exam, “1” is placed on
the elbow flexion line of the worksheet, “2”
on elbow extension and “3” on shoulder
abduction. Then either during the test or
after, test data for the test number on the
Commander unit is recorded on correspond-
ing line of the worksheet. This method facili-
tates documentation during exams by allow-
ing you or staff to complete the worksheet
after the exam is finished.
In this example, test 2 would
correspond to elbow extension on
the worksheet.
8

Helpful Hint: Since the display indexes past old tests stored in memory, this meth-
od is recommended only if all previous tests have been erased.
Assigned Testing Method
This method uses the default test numbers assigned to the test on the worksheet
and flip chart. The assigned numbers on the worksheet and chart correspond to
the test numbers selected on the Commander console. Therefore, Automatic
Indexing™ should not used with this method. Instead, use the “NEXT” button to
select the test number on the Commander unit that correspond to the test num-
ber on the worksheet or chart.
In this example, the test number on the display corresponds
to the pre-printed test number on the worksheet.
This method eliminates the necessity of writing the test number on the worksheet
before or during the exam as with the Sequential Testing Method. Also, when using
this method with Commander Downloader software, the names of the muscle
groups are automatically assigned to the tests.
Helpful Hint: You should be careful to select the proper test number before start-
ing a test, and be extremely careful not to inadvertently continue with the next
automatic test in the series. If you inadvertently begin a test at the next test num-
ber instead of the worksheet number because of Automatic Indexing™, delete the
test by pressing “REVIEW” and holding it while you press “Redo.”
9

Advanced Console Features
Press “REDO” to test the last repetition again. This feature is helpful if the
current test was started inadvertently, was done incorrectly or was for
practice.
Redo a test - If after reviewing exam results, you determine that a test (all
right and left repetitions) needs to be redone, press “REVIEW.” Once in
“Review” mode, press “NEXT” until the correct test number is displayed.
Press and hold “REVIEW” and press “REDO.” Repeat the test.
Important Note: When using “REDO” for a test, the entire test, including
repetitions for the right and left side, are deleted and must be redone.
Review last repetition - To review the measured force for the last repeti-
tion, press “REVIEW” after the repetition is complete. To review other sta-
tistics associated with the test, continue pressing “REVIEW,” and the dis-
play will scroll through all available statistics. To continue testing with the
next repetition, press “TEST CONT.” To erase the repetition and start over,
press “REDO.”
Deleting a test - Press “REVIEW” then press “NEXT” until the correct test
number is displayed. While holding the “REVIEW” button down, press
“Redo.” The entire test, including all right and left side repetitions, will be
deleted.
Reviewing an Exam
An exam can be reviewed at any time, either during testing or after, by
pressing the “REVIEW” button. The last completed repetition will be dis-
played. To review other tests within the exam, press “NEXT” to advance to
the next test with recorded data. When advancing through tests, the
Commander display shows the test number with the right side repetition.
To see left side repetitions and additional statistics press “REVIEW.”
Statistics
To scroll through and review all the statistics for the displayed test, continue press-
ing “REVIEW.”
In the following example, the statistics for test 4 are displayed in the order they
will appear by pressing “REVIEW.” For this example, the number of repetitions was
set at two:
REDO
REDO
NEXT
REVIEW
REDO
TEST
CONT.
REVIEW
REDO
NEXT
REVIEW
REVIEW
NEXT
REVIEW
10

Maximum Force
Repetition 1 Right Side
Maximum Force
Repetition 2 Right Side
CV Right Side Maximum Force
Repetition 1 Left Side
Maximum Force
Repetition 2 Left Side
CV Left Side
Bilateral Deficit
Left Side
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
After all statistics have been selected, the dis-
play circles back to the beginning.
Selecting the next test to review: To view the
next test, press “NEXT.” The display indexes
only to test numbers with data.
11

Statistics Definitions
LBS: In “Test” and “Test Alt” modes, LBS displays force against the
dynamometer in real-time. In “Review” mode, LBS shows maximum
force on dynamometer for the displayed repetition.
% CV: The coefficient of variation for all the repetitions for the indicated side
using the n-1 method.
%Deficit: Bilateral deficit indicating weakness of one side compared to the other.
Deleting an Exam
To erase an exam, turn the Commander console on, then press and hold the “ON/
OFF” button for a minimum of two seconds, or until the unit reactivates. When the
button is pressed unit console will beep and turn off indicating data has been
erased.
Note: All test default values will be retained.
Reports
Muscle testing reports from Muscle Tester Commander can be created several
ways:
1. Use the supplied worksheets to create hard-copy documentation.
2. Optional Easy Docs Plus Software from JTECH Medical is an efficient way to
generate reports using your PC. With Easy Docs Plus you enter muscle testing
data into the software using your keyboard. Easy Docs Plus then maintains the
data, calculates statistics, produces progress bar graphs, generates data reports
and allows you to print narratives from Microsoft Word.
12

The Muscle Tester Dynamometer
Care and Cleaning
Muscle Tester is an electronic device and, therefore, should not be submerged in
liquid or placed in an autoclave. The device should be cleaned with a soft,
non-abrasive cloth dampened with clean water. Do not use solvents, detergents or
harsh disinfectant on the PowerTrack’s plastic body.
Testing pads should be removed from the device for cleaning. Pads can be cleaned
with a mild, non-abrasive detergent and a soft cloth. The metal connecting rod
should be dried thoroughly after the pad is cleaned.
When not in use the device should be stored in the case provided. Avoid dropping
or banging the device against hard objects. Never stand on, pound with or apply
more the 125 lb. of pressure against the dynamometer.
Changing Testing Pads
Muscle Tester features a “quick release” system to make changing testing pads fast
and easy.
To remove a testing pad, grasp the pad with your thumb and index finger at the
notches in the dynamometer so your fingers can pull against the underside of the
pad. Pull the pad straight out from the dynamometer.
To install a testing pad, insert the metal post into the dynamometer receptacle and
press the pad all the way in. Make sure pad is securely in place against load cell
before beginning a test.
Using the Dynamometer
Muscle Tester was designed to fit comfortably in the palm of your hand during
manual muscle testing. It can be used to test with either hand. Its slim profile helps
reduce the “roll-over” effect that can occur with taller dynamometers. However,
Muscle Tester should always be used with your hand under the strap.
The testing pads should be selected according to the surface area where the
dynamometer will be placed. When placing the dynamometer against the forehead
for a cervical flexion test, the flat pad should be used. Likewise, when the
dynamometer is placed against a curved bony area, such as the forearm, the
curved pad should be used. The curved pad can also be rotated in the load cell to
provide the greatest patient comfort during a test.
13

Manual Muscle Testing:
General Considerations
Manual Muscle Testing Precautions
The following are general guidelines to minimize risk of injury to the patient. Please
note that these guidelines are not comprehensive because covering all possible con-
ditions would be impossible. Therefore, final responsibility for the risk of injury to the
patient lies with the examiner.
1. Force increase should be gradual.
2. Patient should be CLOSELY observed for any evidence of pain. The test should be
stopped immediately if this occurs.
Manual Muscle Testing - General Information
Manual muscle testing or grading should be performed when neurological problems
at the nerve root or peripheral nerve are suspected, or if disease or disuse affects the
muscles. Manual muscle testing can help identify specific nerve motor function.
Bilateral testing indicating a weakness in several muscles may further substantiate
disease or injury involving nerve roots or peripheral nerves, as long as disuse or dis-
ease of the fibers of the muscle or disorders of the higher levels of the central ner-
vous system are ruled out.
Manual muscle testing should never be used alone to diagnose, but should be used in
conjunction with other diagnostic testing tools such as the Dualer dual inclinometry
system or Commander Algometer pain/pressure testing. If a rehabilitation program is
initiated, bilateral manual muscle testing should be completed at periodic intervals
along with other diagnostic testing to document treatment efficacy.
Manual Muscle Testing Accuracy
General rules must be followed to insure repeatability and accuracy when using the
Muscle Tester manual muscle tester.
1. If testing bilaterally, the muscles and/or tendons that normally cause the motion
should be palpated bilaterally to help identify substitution by muscles other than
the prime movers. Adjust patient stabilization or position until substitution is
eliminated. If substitution continues, document the nature of the substitution.
2. The lever arm length between the attachment point of the muscle and the
Muscle Tester dynamometer must be the same between repetitions and ses-
sions. Make sure the unit is placed at the same location for each repetition and
test. For multiple repetitions, better accuracy is achieved if the unit remains
placed on the body during all repetitions.
14

3. Ensure the starting point for breaking action is at the same range of motion
position for each test and repetition. This is necessary because of the wide
variations in force the prime movers can oppose depending on the starting
point of breaking action.
4. Determine the plane of motion of the segment and ensure that the Muscle
Tester dynamometer is not sideways or off axis to this motion. Additionally,
apply force in the direction of motion.
5. Always build up resistance smoothly until the position is broken. In general the
break should occur within 2-3 seconds. Prolonging the time to break may
introduce fatigue. Shorter breaks are at higher risk of re-injury or may not allow
for buildup of maximum contraction. For difficult to break segments, two hands
may be required.
Grading Muscle Tests
Traditionally, muscle testing uses a grading system for documentation and
standardization. In the traditional system muscle test grades range from 4/5 “Good/
Normal” to 0/1 “None/Slight Contraction.” With the introduction of the Muscle
Tester manual muscle tester and the JTECH’s IsoTrack isometric testing station, the
system has been modified slightly to encompass the additional diagnostic data
available.
When Should a Muscle Test Be Graded?
Using the traditional subjective method of muscle testing, every test needed to be
graded just for the purpose of documentation. With Commander’s Muscle Tester
muscle testing systems, the actual force values are automatically recorded, so the
need to grade every test is greatly reduced. As a result, tests conducted for
purposes like initial screenings and monitoring progress are not required to be
graded. In addition, tests not graded during the examination, or immediately after,
can be graded at a later date if necessary using the test values recorded on the
worksheet.
According to the AMA Guides to the Evaluation of Permanent Impairment, a muscle
test must be graded if it is to be used as part of an impairment rating. Tests where
the patient cannot exert force against the dynamometer or where the use of a force
gauge is infeasible should also be graded to provide documentation of the test.
Grading with the Muscle Testing Dynamometer
Grade 4 or 5:
These grades are assigned if the patient can provide slight to full resistance against
the dynamometer.
15

1. Patient moderately resists against the examiner. If any resistance occurs, then
the patient has enough strength to provide resistance against the muscle test-
ing dynamometer. If the patient is too weak to provide any resistance, grades
0/1, 2, or 3 should be assigned based on test results obtained without using
the dynamometer.
2. Place the patient in the recommended position and conduct a test using the
dynamometer. Repeat for a minimum of three repetitions to ensure accuracy
and repeatability.
3. Repeat the test for the opposite side.
4. If a strength deficit greater than 15% exists bilaterally when tested with the
dynamometer, the weaker side should be assigned a grade 4. As noted earlier,
a grade is required if the test is to be included in an impairment report.
Grading may be skipped if all that is needed is the bilateral strength compari-
son for showing progress, justifying treatment, or determining the injured/dis-
eased nerves.
Grading without the Muscle Testing Dynamometer
If the subject does not have sufficient strength to resist against the force gauge or
a force gauge test is infeasible, then the following grading system can be used.
Grade 4/5 - Good/Normal: Moderate to full resistance against the examiner.
Grade 3 - Fair: Partial to complete motion against gravity.
Grade 2 - Poor: Partial to complete motion with gravity removed.
Grade 0/1- Zero/Trace: No contraction to slight contraction.
16
© 2016 JTECH Medical All rights reserved. This manual is provided as a service
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