<p>Strength will be evaluated within the patient’s available range of motion. <em>(<em><em>Refer to HJHS Instruction Manual page</em></em>s 11-20 (Section 6 – Strength) and HJHS Instructional Videos as references).</em><em><br /></em></p>
<p>Each identified muscle group for the elbow, knee, and ankle should be strength tested within the patient’s available range of motion and a muscle grade assigned as per the Daniels &amp; Worthingham’s scale. Since all joints move in more than one direction, the direction that is given the <strong>WEAKEST GRADE</strong> is used to determine the strength <strong>SCORE</strong> for each joint which will be automatically generated. Note that the strength <strong>SCORE</strong> is inversely related to the strength <strong>GRADE.</strong></p>
<p>For ankle plantarflexion, a functional unilateral heel raise test in standing is performed. If this is not possible for the patient to do or there is a perceived risk (e.g. of bleeding), assess strength in a non-weight bearing position. Strength grade and score will be downgraded in this situation.</p>