Sensible manual muscle strength testing to evaluate and monitor strength of the intrinsic muscles of the hand: a commentary.

Hand therapists often assess, evaluate, and monitor the status of, and changes in the strength of, the intrinsic muscles of the hand. Some common indications are peripheral and central neuropathies and nerve lacerations and repairs. The therapist will often use a muscle chart that lists all the muscles innervated by the ulnar and median nerves, and all muscles will be tested. Not all muscles in the hand can be sufficiently isolated to grade their strength, nor is it always necessary to test all muscles innervated by a particular nerve to evaluate the presence or extent of motor function impairment or monitor changes. This paper discusses the tests by which changes in strength of the ulnar and median innervated intrinsic muscles can be assessed and the reasons that certain muscles cannot or need not be tested. Information about the reliability of muscle testing is also given.