Surgery – Diagnostic testing – Measuring anatomical characteristic or force applied to or...
Reexamination Certificate
2001-02-12
2004-03-16
Marmor, Charles (Department: 3736)
Surgery
Diagnostic testing
Measuring anatomical characteristic or force applied to or...
C600S595000, C073S379010
Reexamination Certificate
active
06706003
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates to the field of gauging devices and is more particularly concerned with a muscle strength testing method and apparatus allowing simultaneous assessment of the muscular contraction of a selected muscle through direct contact between an examiner and a patient and assessment of the strength of the muscular contraction of the selected muscle through the use of a pressure sensor.
BACKGROUND OF THE INVENTION
Muscle strength can be defined as the ability of a muscle or a group of muscles to produce tension or exert force through the skeletal system. The generally accepted measurement criterion for the maximum tension which can be exerted by a muscle is the maximum amount of force a muscle can exert on a body part. In physiology, this is referred to as the maximum strength of the muscle and might be expressed, for example, in kilograms per square centimeter of muscular section. In day-to-day life with the patient, the strength is usually expressed in kilograms, Newtons, pounds or inch-pounds and Newton-meters.
There are a plurality of situations wherein it is desirable to monitor or test different muscle strength of an individual. This type of examination is commonly used in diagnostic, therapeutic and prevention activities. The tests are typically used to determine difference in strength between individuals and/or to determine strength deficits in a given individual. In such a case, deficits are detected by the comparison of contralateral limb segments or muscle groups. The tests are also typically used to monitor a patient's progress during a period of recovery or rehabilitation. Muscle testing is also used in the design of rehabilitation programs for injured patients or individuals wanting to undertake activities for which they are not properly conditioned.
Although the medical and therapeutic fields have evolved into high-tech sectors using state of the art technology, muscle strength testing which is part of most routine physical examination is still widely performed by a mere manual operation on behalf of an examiner. Muscle strength is typically tested by asking the patient or individual to move actively against the examiner's opposition (commonly called a make test) or to resist against the pressure of the examiner on a part of his/her body (commonly called a brake test) while the patient is asked to maintain a specific posture. The examiner is therefore able to subjectively judge the patient's maximum force, as conventionally called isometric manual muscle testing (MMT). Because of the sensitivity provided by the examiner, this method enables the examiner to assign a grade to indicate the weakness of the muscular contraction and to judge the qualitative aspect of the contraction such as slight shaking, saw-teeth type of effort or the like.
The strength is typically subjectively quantified and graded on a conventional zero to five scale. Although there are no international established standards, the grading scale varies between no muscular contraction detected (0) and active movement against full resistance without evident fatigue corresponding to normal muscle strength (5). Many clinicians make further distinction by using plus or minus signs towards the stronger and weaker end of the scale respectively. Thus, a (4+) grade indicates good but not full strength while a (5−) grade means a trace of weakness.
During the procedure, for purpose of comparison, the unaffected limb of the patient is typically similarly tested. From the hereinabove description, it is quite evident that the common manual method of muscle testing is opened to a large proportion of subjectivity.
Not only is the evaluation potentially unreliable when performed by a same individual but also this problem is compounded in situations wherein different individuals may use different techniques to perform the same testing.
Accordingly, several attempts to standardize manual testing procedures have been made and the prior art shows various devices adapted to measure muscle strength. For the most part, prior art devices suffer from a set of disadvantages including lack of ergonomical features, cumbersomeness, inability to test particular muscles or groups of muscles, complexity, lack of portability, expensiveness and so forth. One major drawback associated with some of the prior art devices is their inability to isolate specific muscles or muscle groups needing to be tested. Also, in the clinical context prior art testers have often proven to be difficult and time consuming to adjust to the specific ergonomical characteristics of the patient.
In order to test various body parts the devices always need to be quickly repositioned, thus failing to provide a practical solution, as opposed to quick displacements of the examiner to support and test these various body parts. As a result, despite the obvious disadvantages of the subjective test of muscle strength, manual testing without instrumentation continues to be the predominant method used in the clinical setting. One of the predominant factors is the so far unequaled ergonomical support provided by the examiner's hands since prior art devices, especially the handheld dynamometers (HHD), are often uncomfortable to the patient and unstable (as opposed to a stabilization provided by a hand-grip).
Accordingly, there exists a need for an improved objective muscle strength testing method and device that uses the comfort and the grip of the naked hand of the examiner as the only direct support assistance and/or resistance.
OBJECTS OF THE INVENTION
It is therefore a general object of the present invention to provide a muscle strength testing method and apparatus that obviates the above-noted disadvantages.
An advantage of the present invention is that the muscle strength testing method and apparatus enables testing of most muscles and group of muscles of a human body.
A further advantage of the present invention is that the muscle strength testing method and apparatus provides sufficient sensitivity to objectively detect anything ranging from extremely small forces or muscle effort (even when the patient is unable to displace his/her body part against natural gravity) to normal large forces generated by limb muscles.
Yet another advantage of the present invention is that the muscle strength testing method and apparatus remains essentially manual in practice and enables simultaneous qualitative subjective and quantitative objective testing of muscles without interfering on or modifying the test itself.
Advantages of the present invention include the fact that the present muscle strength testing method and apparatus is specifically configured so as to be easy to use in a manner closely akin to the testing that examiners such as physicians, therapists, athletic trainers, coaches and the like currently use.
The muscle strength testing method and apparatus can be readily positioned so as to test various muscles or groups of muscles without the need for elaborate attachment to the patient and thus provides for a time efficient solution. Also, the present muscle strength testing method and apparatus affords accurate measurements and repeatability in its strength indication from one test to the next.
The present muscle strength testing method and apparatus by allowing use of a method closely akin to the currently highly performed manual method allows the examiner to obtain both a conventional subjective evaluation of the muscle strength and a more objective dynamometric numerical value of the patient's muscle strength. By allowing the hand of the examiner to provide for resistive forces during the strength evaluation process the muscle strength testing method and apparatus reduces set-up time consumption and sometimes complex set-up procedures.
Furthermore, the present muscle strength testing method and apparatus allows for the elimination of gravity induced biases and thus allows for the evaluation of even very weak muscles.
The present muscle strength testing method and apparatus provides var
Bouchard Julien
Perrad Jacques
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