E X AMINATION
You may want to make a chart something like this and hang it in your examining area,
as a reminder.
33
In muscle
testing, it is
especially
important
to note the
difference
between FAIR
and POOR.
This
is because
FAIR is often
strong enough
to be fairly
useful (for
standing,
walking, or
lifting arm to
eat). POOR
is usually
too weak to
be of much
use.
EVA LUAT ING S T RENGT H OR W E A K NES S O F MUSCLES
CAUTION: To avoid misleading results, check
range of motion BEFORE testing muscle strength.
Strength
rating
Test with the child positioned so that
he lifts the weight of the limb.
NORMAL
(5)
lifts and holds
against strong
resistance
GOOD
(4)
lifts and holds
against some
resistance
FAIR
(3)
lifts own weight
but no more
POOR
(2)
cannot lift own
weight but moves
well without any
weight.
Test with the child positioned so that
he can move the limb without lifting
its weight (by lying on his side).
TRACE
(1)
barely moves
ZERO
(0)
no sigh of
movement
Sometimes with exercise POOR muscles can be strengthened to FAIR; this can
greatly increase their usefulness. It is much less common for a TRACE muscle to
increase to a useful strength (FAIR), no matter how much it is exercised. (However, if
muscle weakness is due to lack of use, as in severe arthritis, rather than to paralysis,
a POOR muscle can sometimes be strengthened with exercise to GOOD or even
NORMAL. Also, in very early stages of recovery from polio or other causes of
weakness, POOR or TRACE strength sometimes returns to FAIR or better.)
disabled village children