Thursday Apr 28, 2022
Scot Morrison - Upgrade your manual muscle test. How to measure strength in clinical practice, minimise error and interpret your findings.
My guest this week is Scot Morrison. Scot is a board certified orthopaedic physical therapist and certified strength coach. In this conversation, Scot summarises six steps for measuring strength in clinical practice. You will learn the importance of accepting uncertainty in measurement, how to minimise error with a standardised testing routine and the importance of interpreting test findings to the person being tested.
This is a discussion aimed at health professionals. Always seek the guidance of a qualified health professional with any questions you may have regarding your health or a medical condition.
In this conversation:
- 0:00 About this episode
- 0:19 About Scot, welcome to Physio Foundations
- 1:39 Scot’s work so far – strength coaching, physical therapy, high performance, management, education and research
- 3:55 Why are you interested in measuring strength in the clinic?
- 6:00 What is strength, how do you define it?
- 7:10 The importance of being reliable when measuring strength
- 7:44 It’s better to say ‘I don’t know’ than to not know and guess
- 8:40 If strength matters, measure it properly
- 10:00 It’s your job to interpret strength testing results to that individual
- 10:40 Example of measuring knee extensor strength after ACL reconstruction
- 11:45 Step 1 – is this measure meaningful right now? Can you test strength without pain?
- 12:25 Step 2 - does the device measure in meaningful units (Newtons)
- 13:05 Step 3 – does the device have the ability to measure force at the rate you require?
- 13:30 Step 4 – set the test up properly. Proper fixation of the patient and device
- 15:45 Step 5 - The line of pull must be 90 degrees to the moment arm
- 16:15 Step 6 – Standardised approach to testing, warm up, instructions, 30 sec- 1 minute rest between efforts, standardised cueing, be consistent
- 19:15 Realise that there is uncertainty in measurement
- 21:03 Torque calculator on Scot’s website. Upgrade your manual muscle test
- 21:45 Why is it important to consider torque and body weight normalised torque?
- 24:45 Testing strength with a device doesn’t add more work and time
- 27:35 Limits of the Oxford scale. Can they lift their limb against gravity
- 28:12 What devices are most useful for measuring strength in the clinic?
- 31:45 Scot’s PhD – are we testing strength and are we testing it well. What is meaningful change?
- 35:20 Scot’s final thoughts. Realise we are dealing with uncertainty and need to make decisions under uncertainty
- 37:48 Scot Morrison PT is not the Australian PM! Angry Tweets from Australians… Funny.
- 39:11 Support this podcast by sharing it
Listen to Scot discuss strength assessment with Luke on the @MonashMRU podcast: https://podcasts.apple.com/au/podcast/how-to-measure-strength-in-your-clinical-practice-with/id1549298610?i=1000558331646
Find out more about Scot here: physiopraxis.co/about
Scot’s Therapeutic Exercise database: physiopraxis.co/physiotherexdatabase
Scot’s torque calculator: physiopraxis.co/torque-calculation-app
Scot mentioned the TinDeq dynamometer: tindeq.com
He also mentioned the JLW dynamometer: https://jlwforce.com/products/praxis-3-500
He also mentioned dynamometer systems by Hawkin Dynamics https://www.hawkindynamics.com/
…and Vald Health: https://valdhealth.com/dynamo/
Scot and I have no conflicts of interest and receive no money or benefits from these companies, we are simply interested in equipment for measuring strength
Follow Scot on Twitter: twitter.com/scotmorrsn
Follow Scot on Instagram: instagram.com/physio_praxis
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Always seek the guidance of a qualified health professional with any questions you may have regarding your health or a medical condition.
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