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| unable to create any visible or noticeable contraction in a specific muscle. This occurs when a muscle is paralyzed, shuch as after a stroke, spinal cord injury, or cervical or lumbar radiculopathy. Sometimes pain can prevent a muscle from contracting at all. |
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| A grade of 1/5 occurs when muscle contraction is noted but no movement occurs. The muscle is not strong enough to lift the particular body part against gravity or move it when in a gravity-reduced position. |
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| This muscle-strength grade is assigned when your muscle can contract but cannot move the body part fully against gravity. When gravity is reduced or eliminated during a change in body position, the muscle is able to move the body part through its full range of motion. |
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| A 3/5 grade means that you are able to fully contract your muscle and move your body part through its full range of motion against the force of gravity. But when resistance is applied, the muscle is unable to maintain the contraction. |
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| A 4/5 grade indicates that the muscle yields to maximum resistance. The muscle is able to contract and provide some resistance, but when your physical therapist presses on the body part, the muscle is unable to maintain the contraction. |
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| This means the muscle is functioning normally and is able to maintain its position even when maximum resistance is applied. |
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| smile, puff cheeks, stick out tongue, raise eyebrows |
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| Rapid rhythmic alternating movements |
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Alternately turning up and down the palms of the hands
Touching thumb-to-fingers |
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| Test Accuracy of movements |
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finger-to-finger test
finger-to-nose
heel-to-shin |
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Romberg test
Standing on one foot |
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observe the gait sequence
heel-toe walking |
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familiar object (key, coin)
tactile agnosia, an inability to recognize objects by touch |
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| distance at which the patient can no longer distinguish two points |
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simultaneously touch two areas on each side of the body
similar sensations should be felt bilaterally |
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| draw a letter, number, or shape on the palm of the patient's hand |
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| touch an area on the patient's skin and withdraw the stimulus |
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| stiff neck or nuchal rigidity |
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| involuntary flexion of the hips and knees when flexing the neck is a positive |
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evaluated by flexing the leg at the knee and hip when the patient is supine, then attempting to straighten the leg
pain in the lower back and resistance to straightening the leg at the knee constitute a positive Kernig sign |
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