Validation of Manual Muscle Testing (MMT) in children and adolescents with cerebral palsy.

Abstract

Weakness is a major impairment in many movement disorders, including cerebral palsy (CP), which presents as a decrease in muscle strength. Manual muscle testing (MMT) is very popular in clinical practice, however it has many limitations. (1) Whether maximum voluntary contraction (MVC) measures differ across clinical MMT groups; (2) Whether an association exists between clinical MMT score groups and instrumental MVC measures. Twenty-one participants with spastic CP were recruited (11 females and 10 males; age = 13.46±3.62 years). To achieve the aims of the study, we investigated the relationship between qualitative (MMT) and instrumental (MVC) measures of knee flexor muscles' strength in patients with CP. MVC values increased somewhat proportionally with increasing MMT score group (p = 0.032, MS = 207.54, F = 3.75). The differences in MVC values was only statistically significant between score groups 3 and 5. A weak correlation (R = 0.4, MVC = -2.54 + 4.50 MMT, p < 0.01) was found between measured MVCs and the MMT score groups. In pediatric research studies, instrumental MVC should be preferred over MMT scoring. Also, MMT score groups higher than 3 should be modified in clinical testing of children and adolescents with cerebral palsy.