Bittmann Frank N, Dech Silas, Aehle Markus, Schaefer Laura V
Division Regulative Physiology and Prevention, Department Sports and Health Sciences, University of Potsdam, 14476 Potsdam, Germany.
Diagnostics (Basel). 2020 Nov 25;10(12):996. doi: 10.3390/diagnostics10120996.
The manual muscle test (MMT) is a flexible diagnostic tool, which is used in many disciplines, applied in several ways. The main problem is the subjectivity of the test. The MMT in the version of a "break test" depends on the tester's force rise and the patient's ability to resist the applied force. As a first step, the investigation of the reproducibility of the testers' force profile is required for valid application. The study examined the force profiles of = 29 testers ( = 9 experiences (Exp), = 8 little experienced (LitExp), = 12 beginners (Beg)). The testers performed 10 MMTs according to the test of hip flexors, but against a fixed leg to exclude the patient's reaction. A handheld device recorded the temporal course of the applied force. The results show significant differences between Exp and Beg concerning the starting force (p = 0.029), the ratio of starting to maximum force (p = 0.005) and the normalized mean Euclidean distances between the 10 trials (p = 0.015). The slope is significantly higher in Exp vs. LitExp ( = 0.006) and Beg ( = 0.005). The results also indicate that experienced testers show inter-tester differences and partly even a low intra-tester reproducibility. This highlights the necessity of an objective MMT-assessment. Furthermore, an agreement on a standardized force profile is required. A suggestion for this is given.
徒手肌力测试（MMT）是一种灵活的诊断工具，在许多学科中都有应用，应用方式多种多样。主要问题在于测试的主观性。“对抗试验”版本的MMT取决于测试者施加力的增加以及患者抵抗所施加力的能力。作为第一步，为了有效应用，需要研究测试者力曲线的可重复性。该研究检查了29名测试者的力曲线（9名经验丰富者（Exp），8名经验较少者（LitExp），12名初学者（Beg））。测试者根据髋屈肌测试进行10次MMT，但对抗固定的腿部以排除患者的反应。一个手持设备记录了所施加力的时间过程。结果显示，在起始力方面（p = 0.029）、起始力与最大力的比值方面（p = 0.005）以及10次试验之间的标准化平均欧几里得距离方面（p = 0.015），经验丰富者与初学者之间存在显著差异。经验丰富者与经验较少者（p = 0.006）和初学者（p = 0.005）相比，斜率显著更高。结果还表明，经验丰富的测试者之间存在测试者间差异，甚至部分测试者内的可重复性较低。这突出了客观MMT评估的必要性。此外，需要就标准化的力曲线达成一致。为此给出了一个建议。
