{"id":"https://openalex.org/W4408447133","doi":"https://doi.org/10.1002/pmrj.13348","title":"Manual muscle testing of upper limb muscle strength in persons with tetraplegia undergoing surgical restoration of elbow extension: A scoping review","display_name":"Manual muscle testing of upper limb muscle strength in persons with tetraplegia undergoing surgical restoration of elbow extension: A scoping review","publication_year":2025,"publication_date":"2025-03-14","ids":{"openalex":"https://openalex.org/W4408447133","doi":"https://doi.org/10.1002/pmrj.13348","pmid":"https://pubmed.ncbi.nlm.nih.gov/40085023"},"language":"en","primary_location":{"id":"doi:10.1002/pmrj.13348","doi":"https://doi.org/10.1002/pmrj.13348","is_oa":false,"landing_page_url":"https://doi.org/10.1002/pmrj.13348","pdf_url":null,"source":{"id":"https://openalex.org/S46247591","display_name":"PM&R","issn_l":"1934-1482","issn":["1934-1482","1934-1563"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","medline","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"PM&R","raw_type":"journal-article"},"volume":null,"type":"review","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5044054656","display_name":"Sabrina Koch\u2010Borner","orcid":"https://orcid.org/0000-0002-0015-0282","observed_orcids":["https://orcid.org/0000-0002-0015-0282"]},"institutions":[{"id":"https://openalex.org/I161941770","display_name":"University of Lucerne","ror":"https://ror.org/00kgrkn83","country_code":"CH","type":"education","lineage":["https://openalex.org/I161941770"]},{"id":"https://openalex.org/I4210119191","display_name":"Swiss Paraplegic Center","ror":"https://ror.org/01spwt212","country_code":"CH","type":"healthcare","lineage":["https://openalex.org/I4210119191"]},{"id":"https://openalex.org/I4210155534","display_name":"Swiss Paraplegic Research","ror":"https://ror.org/04jk2jb97","country_code":"CH","type":"facility","lineage":["https://openalex.org/I4210155534"]}],"countries":["CH"],"is_corresponding":true,"raw_author_name":"Sabrina Koch\u2010Borner","raw_affiliation_strings":["Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland","Swiss Paraplegic Center, Nottwil, Switzerland","Swiss Paraplegic Research, Nottwil, Switzerland"],"raw_orcid":"https://orcid.org/0000-0002-0015-0282","affiliations":[{"raw_affiliation_string":"Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland","institution_ids":["https://openalex.org/I161941770"]},{"raw_affiliation_string":"Swiss Paraplegic Center, Nottwil, Switzerland","institution_ids":["https://openalex.org/I4210119191"]},{"raw_affiliation_string":"Swiss Paraplegic Research, Nottwil, Switzerland","institution_ids":["https://openalex.org/I4210155534"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5024801117","display_name":"Ursina Arnet","orcid":"https://orcid.org/0000-0003-1101-4267","observed_orcids":["https://orcid.org/0000-0003-1101-4267"]},"institutions":[{"id":"https://openalex.org/I4210155534","display_name":"Swiss Paraplegic Research","ror":"https://ror.org/04jk2jb97","country_code":"CH","type":"facility","lineage":["https://openalex.org/I4210155534"]}],"countries":["CH"],"is_corresponding":false,"raw_author_name":"Ursina Arnet","raw_affiliation_strings":["Swiss Paraplegic Research, Nottwil, Switzerland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Swiss Paraplegic Research, Nottwil, Switzerland","institution_ids":["https://openalex.org/I4210155534"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5071227221","display_name":"Ann\u2010Sofi Lamberg","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801112325","display_name":"Sahlgrenska University Hospital","ror":"https://ror.org/04vgqjj36","country_code":"SE","type":"healthcare","lineage":["https://openalex.org/I2801112325"]}],"countries":["SE"],"is_corresponding":false,"raw_author_name":"Ann\u2010Sofi Lamberg","raw_affiliation_strings":["Center for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital/M\u00f6lndal M\u00f6lndal Sweden","Physiotherapy Department, Sahlgrenska University Hospital  Gothenburg Sweden"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Center for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital/M\u00f6lndal M\u00f6lndal Sweden","institution_ids":["https://openalex.org/I2801112325"]},{"raw_affiliation_string":"Physiotherapy Department, Sahlgrenska University Hospital  Gothenburg Sweden","institution_ids":["https://openalex.org/I2801112325"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5047896717","display_name":"Silvia Schibli","orcid":"https://orcid.org/0009-0008-1913-9711","observed_orcids":["https://orcid.org/0009-0008-1913-9711"]},"institutions":[{"id":"https://openalex.org/I4210119191","display_name":"Swiss Paraplegic Center","ror":"https://ror.org/01spwt212","country_code":"CH","type":"healthcare","lineage":["https://openalex.org/I4210119191"]}],"countries":["CH"],"is_corresponding":false,"raw_author_name":"Silvia Schibli","raw_affiliation_strings":["Swiss Paraplegic Center, Nottwil, Switzerland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Swiss Paraplegic Center, Nottwil, Switzerland","institution_ids":["https://openalex.org/I4210119191"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5050149929","display_name":"Jennifer Ann Dunn","orcid":"https://orcid.org/0000-0002-2894-7533","observed_orcids":["https://orcid.org/0000-0002-2894-7533"]},"institutions":[{"id":"https://openalex.org/I80281795","display_name":"University of Otago","ror":"https://ror.org/01jmxt844","country_code":"NZ","type":"education","lineage":["https://openalex.org/I80281795"]}],"countries":["NZ"],"is_corresponding":false,"raw_author_name":"Jennifer Dunn","raw_affiliation_strings":["Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand","institution_ids":["https://openalex.org/I80281795"]}]}],"institutions":[],"countries_distinct_count":3,"institutions_distinct_count":5,"corresponding_author_ids":["https://openalex.org/A5044054656"],"corresponding_institution_ids":["https://openalex.org/I161941770","https://openalex.org/I4210119191","https://openalex.org/I4210155534"],"apc_list":{"value":3470,"currency":"USD","value_usd":3470},"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"17","issue":"7","first_page":"850","last_page":"860"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12459","display_name":"Nerve Injury and Rehabilitation","score":0.8452000021934509,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12459","display_name":"Nerve Injury and Rehabilitation","score":0.8452000021934509,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10925","display_name":"Spinal Cord Injury Research","score":0.025100000202655792,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10630","display_name":"Orthopedic Surgery and Rehabilitation","score":0.02019999921321869,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/tetraplegia","display_name":"tetraplegia","score":0.9240000247955322},{"id":"https://openalex.org/keywords/manual-muscle-testing","display_name":"manual muscle testing","score":0.8840000033378601},{"id":"https://openalex.org/keywords/muscle-strength-testing","display_name":"muscle strength assessment","score":0.6850000023841858},{"id":"https://openalex.org/keywords/nerve-transfer","display_name":"nerve transfer","score":0.9929999709129333},{"id":"https://openalex.org/keywords/shoulder-muscle-strength","display_name":"shoulder muscle strength","score":0.8759999871253967},{"id":"https://openalex.org/keywords/standardized-reporting","display_name":"standardized reporting","score":0.35499998927116394},{"id":"https://openalex.org/keywords/preoperative-and-postoperative-evaluation","display_name":"preoperative and postoperative assessment","score":0.6389999985694885}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8715555667877197},{"id":"https://openalex.org/C2781306077","wikidata":"https://www.wikidata.org/wiki/Q944758","display_name":"Tetraplegia","level":4,"score":0.8261365294456482},{"id":"https://openalex.org/C2781184374","wikidata":"https://www.wikidata.org/wiki/Q42586","display_name":"Elbow","level":2,"score":0.6732747554779053},{"id":"https://openalex.org/C2780713489","wikidata":"https://www.wikidata.org/wiki/Q7699654","display_name":"Tendon transfer","level":3,"score":0.550125002861023},{"id":"https://openalex.org/C99508421","wikidata":"https://www.wikidata.org/wiki/Q2678675","display_name":"Physical medicine and rehabilitation","level":1,"score":0.5451123714447021},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.4962964653968811},{"id":"https://openalex.org/C2909532979","wikidata":"https://www.wikidata.org/wiki/Q279039","display_name":"Flexor Carpi Ulnaris","level":4,"score":0.46304160356521606},{"id":"https://openalex.org/C2780105995","wikidata":"https://www.wikidata.org/wiki/Q232358","display_name":"Tendon","level":2,"score":0.39395731687545776},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.35729920864105225},{"id":"https://openalex.org/C2778931672","wikidata":"https://www.wikidata.org/wiki/Q254580","display_name":"Ulnar nerve","level":3,"score":0.35385197401046753},{"id":"https://openalex.org/C2778334475","wikidata":"https://www.wikidata.org/wiki/Q1415275","display_name":"Spinal cord injury","level":3,"score":0.1902129054069519},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.0},{"id":"https://openalex.org/C2780775167","wikidata":"https://www.wikidata.org/wiki/Q9606","display_name":"Spinal cord","level":2,"score":0.0}],"mesh":[{"descriptor_ui":"D004550","descriptor_name":"Elbow","qualifier_ui":"Q000503","qualifier_name":"physiopathology","is_major_topic":true},{"descriptor_ui":"D004550","descriptor_name":"Elbow","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":true},{"descriptor_ui":"D004551","descriptor_name":"Elbow Joint","qualifier_ui":"Q000503","qualifier_name":"physiopathology","is_major_topic":true},{"descriptor_ui":"D004551","descriptor_name":"Elbow Joint","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011782","descriptor_name":"Quadriplegia","qualifier_ui":"Q000503","qualifier_name":"physiopathology","is_major_topic":true},{"descriptor_ui":"D011782","descriptor_name":"Quadriplegia","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":true},{"descriptor_ui":"D016059","descriptor_name":"Range of Motion, Articular","qualifier_ui":"Q000502","qualifier_name":"physiology","is_major_topic":false},{"descriptor_ui":"D016067","descriptor_name":"Nerve Transfer","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D018482","descriptor_name":"Muscle, Skeletal","qualifier_ui":"Q000503","qualifier_name":"physiopathology","is_major_topic":true},{"descriptor_ui":"D034941","descriptor_name":"Upper Extremity","qualifier_ui":"Q000503","qualifier_name":"physiopathology","is_major_topic":true},{"descriptor_ui":"D053580","descriptor_name":"Muscle Strength","qualifier_ui":"Q000502","qualifier_name":"physiology","is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.1002/pmrj.13348","doi":"https://doi.org/10.1002/pmrj.13348","is_oa":false,"landing_page_url":"https://doi.org/10.1002/pmrj.13348","pdf_url":null,"source":{"id":"https://openalex.org/S46247591","display_name":"PM&R","issn_l":"1934-1482","issn":["1934-1482","1934-1563"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","medline","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"PM&R","raw_type":"journal-article"},{"id":"pmid:40085023","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/40085023","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"PM & R : the journal of injury, function, and rehabilitation","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9940000176429749,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/systematic-review","display_name":"Systematic Review"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":55,"referenced_works":["https://openalex.org/W645537944","https://openalex.org/W1958066813","https://openalex.org/W1964099579","https://openalex.org/W1969174184","https://openalex.org/W1971453070","https://openalex.org/W1980220858","https://openalex.org/W1980439449","https://openalex.org/W1983629682","https://openalex.org/W1984679212","https://openalex.org/W1988528875","https://openalex.org/W2013420986","https://openalex.org/W2019651994","https://openalex.org/W2021598699","https://openalex.org/W2028074097","https://openalex.org/W2030096729","https://openalex.org/W2035407151","https://openalex.org/W2040839202","https://openalex.org/W2058607479","https://openalex.org/W2059296307","https://openalex.org/W2061467792","https://openalex.org/W2062509597","https://openalex.org/W2065915206","https://openalex.org/W2078792833","https://openalex.org/W2084001347","https://openalex.org/W2087848639","https://openalex.org/W2106195663","https://openalex.org/W2109419579","https://openalex.org/W2136784195","https://openalex.org/W2164199438","https://openalex.org/W2261406464","https://openalex.org/W2291835894","https://openalex.org/W2342448983","https://openalex.org/W2346378836","https://openalex.org/W2399578637","https://openalex.org/W2406772498","https://openalex.org/W2462055868","https://openalex.org/W2467667385","https://openalex.org/W2623066885","https://openalex.org/W2891378911","https://openalex.org/W2911071981","https://openalex.org/W2944707580","https://openalex.org/W2953598028","https://openalex.org/W2960035276","https://openalex.org/W2995004218","https://openalex.org/W3118615836","https://openalex.org/W3164970519","https://openalex.org/W3179065326","https://openalex.org/W3194549361","https://openalex.org/W4206973967","https://openalex.org/W4230607469","https://openalex.org/W4288056496","https://openalex.org/W4289731480","https://openalex.org/W4310131919","https://openalex.org/W4319303293","https://openalex.org/W4401768450"],"related_works":["https://openalex.org/W2135795009","https://openalex.org/W3194549361","https://openalex.org/W2415911461","https://openalex.org/W7095737307","https://openalex.org/W2982811775","https://openalex.org/W2032044675","https://openalex.org/W2087848639","https://openalex.org/W2029377677","https://openalex.org/W2048088915","https://openalex.org/W2028074097"],"abstract_inverted_index":{"Tetraplegia":[0],"often":[1],"leads":[2],"to":[3,8,51,88,127,186,285],"upper":[4],"limb":[5,129],"disability":[6],"due":[7],"triceps":[9],"paralysis,":[10],"affecting":[11],"workspace":[12],"and":[13,29,43,60,80,83,100,109,116,124,138,150,174,188,207,219,276,301],"mobility.":[14],"Restoring":[15],"elbow":[16,61,69,151,158,255],"extension":[17,70,159,224,256],"via":[18],"muscle-tendon":[19],"or":[20,146],"nerve":[21,210],"transfer":[22,133,136],"requires":[23],"preoperative":[24],"donor":[25],"muscle":[26,33,62,152,245,270,278],"strength":[27,63,153,213,225],"assessment":[28,145],"postoperative":[30,277],"evaluation.":[31],"Manual":[32],"testing":[34,81,281],"(MMT)":[35],"is":[36,55,179,264,283],"common,":[37],"but":[38,230,247],"inconsistencies":[39],"in":[40,64,86,97,102,156,161,217,221,233,259],"grading":[41,76],"systems":[42],"procedures":[44,82],"hinder":[45],"cross-study":[46],"comparisons.":[47],"This":[48],"study":[49,168],"aims":[50],"examine":[52],"how":[53,177],"MMT":[54,87,155,178,288],"reported":[56,228],"for":[57,90,244,268],"assessing":[58],"shoulder":[59,149],"patients":[65],"with":[66,261],"tetraplegia":[67,162],"undergoing":[68],"restoration.":[71],"The":[72,118],"review":[73],"focuses":[74],"on":[75,205,254],"systems,":[77],"targeted":[78],"muscles,":[79],"positions":[84,242,249],"used":[85,243],"advocate":[89],"standardization.":[91],"A":[92,192],"literature":[93],"survey":[94],"was":[95,214,226],"conducted":[96],"September":[98,103],"2021":[99],"repeated":[101],"2023":[104],"across":[105],"five":[106,238],"databases:":[107],"Allied":[108],"Complementary":[110],"Medicine":[111],"Database,":[112],"Embase,":[113],"Medline,":[114],"CINAHL,":[115],"Scopus.":[117],"search":[119],"strategy":[120],"utilized":[121],"subject":[122],"headings":[123],"keywords":[125],"related":[126],"\"upper":[128],"reconstructive":[130],"surgery,\"":[131,134,137],"\"tendon":[132],"\"nerve":[135],"\"tetraplegia.\"":[139],"Studies":[140],"describing":[141],"clinical":[142],"information":[143],"about":[144],"outcomes":[147,258],"of":[148,176,194,235,274,293],"using":[154],"surgical":[157,170],"restoration":[160,257],"were":[163,183],"included.":[164],"Extracted":[165],"data":[166,182],"included":[167],"characteristics,":[169],"intervention,":[171],"muscles":[172],"tested,":[173],"description":[175],"performed.":[180],"These":[181],"then":[184],"analyzed":[185],"categorize":[187],"interpret":[189],"existing":[190],"practices.":[191],"total":[193],"29":[195],"studies":[196,239,253],"met":[197],"the":[198,241,291],"inclusion":[199],"criteria.":[200],"Among":[201],"these,":[202],"66%":[203],"focused":[204],"muscle-tendon,":[206],"34%":[208],"addressed":[209],"transfers.":[211],"Donor":[212],"assessed":[215],"preoperatively":[216,232],"55%":[218],"postoperatively":[220,229],"34%.":[222],"Elbow":[223],"consistently":[227],"only":[231],"83%":[234],"studies.":[236],"Only":[237],"specified":[240],"testing,":[246],"these":[248],"varied.":[250],"Despite":[251],"numerous":[252],"people":[260],"tetraplegia,":[262],"there":[263],"no":[265],"consistent":[266],"approach":[267],"reporting":[269,273,300],"strength.":[271],"Consistent":[272],"pre-":[275],"strength,":[279],"including":[280],"positions,":[282],"required":[284],"obtain":[286],"standardized":[287],"positions.":[289],"Similarly,":[290],"adoption":[292],"a":[294],"universal":[295],"scale":[296],"could":[297],"improve":[298],"outcome":[299],"synthesis.":[302]},"counts_by_year":[],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2025-03-15T00:00:00"}