MRC Scale | Muscle Strength Grading

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This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. Let Kai help you understand the theory behind graded MRC muscle strength testing using the knee joint (Quadriceps) as an example.
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[@Muslimdoctor.1]

Grade 0= no movement
Grade 1=slight active without movement of limb
Grade 2= full range of movement without gravity
Grade 3=full range of movement against gravity without resistance offered by examinar
Grade 4= full range of movement against gravity with moderate resistance offered by examinar
Grade 5=full range of movement against gravity with full resistance offered by examinar

[@Mikaela-sw9mp]

Thank you so much. I have watched all of your playlist videos. I even have learnt techniques and special tests that were not taught during physio school. In my opinion, your videos and physiopedia are some of the best physiotherapy content on the internet. Keep doing what you're doing. From Australia.

[@zen2911]

Concise and very helpful thanks for making this mate

[@Physiotutors]

Ur welcome Wechat!

[@Nadasistschoen]

Thanks! From a medical student in New Zealand... I love your channel!

[@mrghost8739]

Thank you for the fast and informative video

[@Physiotutors]

Ur welcome!

[@sarithar3455]

From India.clearly understand.thank you

[@mybaby4935]

best medical channel ever ..hellow from iraq

[@Physiotutors]

Thanks! Appreciate it

[@rosybala2223]

very educational. Thanks a lot sir!

[@Physiotutors]

Ur welcome, thanks for subscribing to our channel!

[@Ameejack]

Very great demo!

[@Suda11]

As your other videos, a very helpful and educative video. Thank you so much

[@Physiotutors]

No worries Ali, happy to help!

[@drshinesha8467]

Great work sir...

[@scottie56]

Is the MRC scale also known as the Oxford Scale?
I'm an undergrad and have only come across the term 'Oxford Scale' before.
Many thanks.

[@Physiotutors]

to our knowledge - YES! Different countries, different terms I guess...

[@fatimashaikh-vt7id]

THANKYOU SO MUCH 😍

[@user-wq6hr9xi2n]

Good as always, thanks

[@Physiotutors]

Thanks 🙏🏼

[@khalidazia2507]

Thanks so mc for subtitle👍👍

[@gizellamonoki]

Fab!! Thank you!! Very practical and clear.

[@tadasm.3265]

The video these guys made I just Lovett.

[@Maxillz]

I had grade 0 for a month after surgery, was the weirdest thing ever, then it suddenly came back

[@wahyuadipratama3011]

makasih bang videonya semoga sehat selalu, panjang umur, berkah ilmunya.🙏

[@ArnoldMambo]

This is nice 👍

[@gabrielmbarrios]

can you make a video about muscle strength assessment using a sphygmomanometer please? And if posible, not only the grip strength. Thank you for the great content!

[@imveryhungry112]

This guy is smart

[@lady9815]

Thank's!!! I love this video!!

[@Physiotutors]

+lady9815 cool, glad u like it and thx for following!!!

[@1809ines]

Thank you so much, this video is perfectly

[@nidawaseem3041]

Thanks a lot sir....its very helpful to me....👌

[@Physiotutors]

you're welcome :)

[@aigerimk9015]

Thank u

[@jawahirsaif]

Thank u so much ... very simple and informative 👍.

[@yogeshchawla6213]

Thank you.

[@Physiotutors]

you're welcome

[@sayadanyshal2060]

Vry helpful

[@ahmedalbasri7280]

Very nice vedio ..thanks so much ..dr .ahmed from karbala .iraq .

[@jacobkuruvilla4502]

Great videos!!! Clear instructions👍
Could you make a video of range of motion measurements using goniometer, inclinometer mentioning anatomical landmarks. Thanks

[@siphesihleenock1549]

physiotutors big up good work

[@Physiotutors]

thanks Siphesihle!

[@hashmibrothers4981]

this video helpedme

[@Physiotutors]

Happy to hear!

[@hibaramona1771]

Very useful thanks

[@dr.z492]

Thank uuuuu 🤍

[@Designworld_3]

Thanks sir it becomes very helpful 😊

[@mickiimickii8363]

Amazing

[@ore6582]

excuse me, how about 4-/5 and 4+/5?

[@kasamhse817]

Thank u ❤

[@katz8358]

thank you!

[@Physiotutors]

Ur welcome!

[@abdulhamid-xp7kf]

Very nice

[@rawdaswilam3800]

Good job❤❤

[@Physiotutors]

Happy you like it Sas!

[@healthandwlness]

Thanks so much

[@ellapeters_]

Big help❤️

[@Physiotutors]

Glad we could help!

[@Maryamalamee]

Thank you so much 💚💚💚💚

[@princess-dh9rj]

Very helpful thank u so much

[@dr.vijaychoudhary3296]

Thank you sir

[@Physiotutors]

Ur welcome Vijay!

[@1ExplosionsHurt]

thanks

[@sergeyryabov7262]

Thank you!

[@emilycuster5372]

These videos are sooo helpful. Anyone else catch the subtle fart at 0:47?

[@Physiotutors]

Haha, we are like girls. We don't fart!;)
But honestly believe that it was Andreas pushing the back of the knee into the bench

[@emilycuster5372]

@@Physiotutors Haha, wasn't expecting a reply. I'll take your word for it ;)

[@karansolanki82]

Thanks a lot ❤️

[@tomweber9041]

Hy, how would you do a resistance test for the abdominal muscles to test strength using the MRC scale?
Thank you so much!!

[@Physiotutors]

That's going to be tough.
Crunch, and crunch with resistance. (check the DOHA agreement video, which shows how to do it).
Grade 2 is going to be difficult

[@tomweber9041]

@@Physiotutors Thank you soo much! :)

[@user-kt3cp3ht5h]

شكرا الك❤🌷

[@natdeu]

Thank you!!

[@Physiotutors]

No worries - thanks for watching!

[@luisa-mn5cq]

movement up to a partial range of motion in a elimnated gravity is any case grade 2?
and and likewise, a partial range of motion against gravity and no resistance is grade 3?

[@Physiotutors]

Hi Luisa, if your patient is able to move through the whole ROM without gravity, it is MRC grade 2.
If he is able to move through full ROM against gravity (and no futher resistance) you assign him an MRC grade 3.

[@DrMD-ve2gh]

Thank you 😍😍😍

[@Physiotutors]

You’re welcome 😊

[@jojoghareeb791]

Please can you make video like this for shoulder muscles all movements

[@Physiotutors]

check resisted isometric testing for the shoulder

[@rqa327]

Thank youuuuuu

[@aishwaryarathod6937]

Can you explain grade wise strengthening program?

[@rofaidaayoub3244]

why you did not explain (minus 2,3)and plus2,3
Thanks about the vedio

[@Physiotutors]

Reliability is questionnable with the 0-5 rating already - all the plusses and minusses make it just more unreliable and confusing!

[@rofaidaayoub3244]

Thanks ♡

[@lowyeeliang7003]

Thank you. But my supervisors does not agree with this and insist on using the plus and minusses. Is there an article for the standardised resistance?

[@samaradel8346]

Good job 🌷🌷🌷

[@dxstar7597]

Thanks my bro

[@Physiotutors]

You're welcome bro!

[@yasinsurve3888]

Hi.. it's very knowledgeable video

[@hudashaikh4388]

Thank u it was helpful

[@Physiotutors]

Ur welcome Huda!

[@shimarezaeikhoramnani3247]

Thank you soooooooooooo much you are the best☺☺

[@Physiotutors]

No worries, thanks a lot for following!;)

[@Gibbonyoga]

Great video. I there a rule on how many repetition the patient should be able to do ?
Also it would be great if you could give an order in which muscles should be tested to prevent the patient to change position to often ? Let s say in a hospital environnement for example (patient room) .

[@nujxad]

Is this different from the Kendall version where if you can’t move the patients leg from the extended position it’s a 5. If you can break the extension hold it’s a 4?

[@Physiotutors]

In general we know from research that distinguishing between a 4 or a 5 is not reliable.
What you mention would also very much depend on the patient's general strength and your strength as the examiner - don't see any inter-rater reliability here.

[@nujxad]

Physiotutors thank you for the reply

[@badaryasin562]

good

[@Physiotutors]

Thx Badar!

[@yeonmj3527]

Thanks a lot!!!!

[@Physiotutors]

+JoungBella thank you for subscribing!

[@user-cx5nk5up1p]

For geriatric patients who have age appropriate weakness bilaterally, do you rate that as 4/5 or 5/5?

[@dancebd470]

not bad good ,,,tnx you

[@cesarbanuelos1753]

There is a guide to do this with every single muscle?

[@salwahassan2107]

What about unconscious patient, how can i assess muscle strength?

[@Angel-bx8fz]

Muscle and bone power

[@venkatsripathi9121]

thank you

[@Physiotutors]

Ur welcome Venkat! thanks for following!

[@annabeljade255]

hi, could you explain the length of lever arm principle during grade 4-5 muscle tests?

[@clearanatomy5608]

Can this be done for all muscles??knee is easy..i find it tough for other muscles like how to position

[@soulatoutou8588]

But in icu has special MRC specipheque muscles

[@jjay11a]

Guys, are we just going to ignore that this man eliminated gravity?? :O Teach me this

[@Physiotutors]

Well not literally 😉 but supporting the leg and then performing knee extension in the transversal plane "eliminates" gravity as much as possible

[@moniqueribeiro2709]

Olá, coloca legenda em português nos seus vídeos. Sou fisioterapeuta do RJ/ Brasil. Obrigada!

[@Physiotutors]

Thanks!

[@amandeepsingh-mj3tp]

Grade 3,4,5 doesn't work. Can it be diagnosed ?

[@IBMyositis]

Kai, I am preparing a youtube video for people with a skeletal muscle disease called Inclusion Body Myositis, and talk about the MRC and MMT they experience during their evaluations. Can I reference this video in the comment section?

[@Dakalo25]

What is the principle of assessment of muscle strength?

[@Physiotutors]

What do you mean with principle?

[@alexander4ever26]

What is the difference between MRC and MMT grading?

[@Physiotutors]

No idea to be honest, we have learned and used MRC only.

[@yangqian8617]

​@@Physiotutors the method of testing grade 4 and 5 seems different

[@jrs18ph]

What if patient is sedated? How to rate the muscle strength?

[@Physiotutors]

In this case I would say: Use your own judgement to which degree a patient's strength is impaired by the sedative...

[@jrs18ph]

thanks :)

[@wiamrafai]

J ai besoin celle de la hanche svp

[@shahzadisaniyamehadi1471]

Is difference occurs with male and female physios to assess MMT

[@Physiotutors]

Unreliable to distinguish between 4 and 5 for both genders

[@bigmock141]

On grade 5 what if Superman give the full resistance to the subject?

[@Physiotutors]

The world collapses

[@anvitatelang6780]

How and when do you do a break test ?

[@Physiotutors]

In the videos we are showing "make" tests, so just an isometric contraction against resistance.
In a break test you would push through the isometric resistance of the patient. Just two different ways of testing strength.

[@anvitatelang6780]

Thank you for the reply

[@dkhle2880]

what about advanced grade such as 2+ or 2- and 3+ etc....?

[@Physiotutors]

Totally unreliable, especially when trying to differentiate between 4 and 5.
In those cases a hand-held dynamometer can help.

[@dkhle2880]

Thank you

[@sasankamahanta7090]

Is the MRC scale also known as MMT (manual muscle testing)????

[@Physiotutors]

Same principle - so yes

[@yangqian8617]

@@Physiotutorswould you watch the videos of MMT testing?

[@sararafiee6426]

Always saving my ass from practical exam😅❤❤

[@Physiotutors]

We’re getting you that degree! But the fun begins after that 👍🏼 and we will still have your back and provide you with the necessary tools to be the best clinician you can be

[@samaradel8346]

طيب فيه +٥ او _٥

[@brownky3]

Wait, if I lie on my side, I can eliminate gravity? Amazing!

[@Physiotutors]

Yes, that's why we use a weighted blanket to sleep. Hated waking up being stuck to the ceiling

[@etomidateem222]

eliminating gravity, you can just move limb sideways while patient is comfortably lying supine , no?

[@michellewong9572]

🤣

[@BG-yf2vt]

thanks

[@Physiotutors]

+BOTH ABDULLAH You´re welcome!

[@situnarout8844]

Thanks sir

[@Physiotutors]

Thank you!