Patients who report on weakness to my tiredness (fatigue), clumsiness or real muscle weakness. Therefore, the examiner must characterize accurately, which includes the exact location, the time of occurrence, deteriorating and ameliorating factors and symptoms associated symptoms.
See also How to evaluate the Motorized System and Introduction to Neurological examination.) Patients who report weakness, fatigue can (fatigue), clumsiness or real muscle weakness mine. Therefore, the examiner must characterize accurately, which includes the exact location, the time of occurrence, deteriorating and ameliorating factors and symptoms associated symptoms. The extremities are examined for weakness (Absinktendenz outstretched limb), tremor, and other involuntary movements. The strength of specific muscle groups tested against resistance and then compared one side of the body with the other. However, pain can inhibit full force development. In hysterical or artificial paralysis of the resistance to movement in the beginning may be normal, followed by a sudden decline or patients do not properly use the supporting muscles. For example, use real patients with deltoid muscle weakness auxiliary muscles that tilt away her torso and neck from the weak deltoids because they want to keep the examiner that it eliminates its weakness. In contrast, (z. B. due to Simulate) tend in patients with artificial deltoid muscle weakness shoulder and head in the direction of the weak deltoid to tilt when the muscle is overcome, indicating their lack of effort. A discrete weakness can be seen in. A decreased arm swing when walking, a Pronationstendenz at arm, the reduced spontaneous use of a limb, an outwardly rotated leg, a slowing fast alternating movement or a fine motor disorder (such as ability to be buttoned, opening a safety pin or removal of a match from the box). The power development should be graduated. The following scale, originally by the British Medical Research Council (MRC scale) developed is used worldwide,: 0: No visible muscle contraction 1: Visible muscle contraction with no or hardly noticeable movement 2: movement of the limbs, not against gravity 3: Motion against gravity but not against resistance 4: movement against at least a little resistance by the examiner 5: Full power development problem with this and similar scale is the wide range of forces between grade 4 and 5. the distal force can semi-quantitatively using a hand ergometer or which is compressed by the patient an inflated cuff blood pressure are measured. A functional analysis often provides a better picture of the relationship between force and effect. If the patient is performing various maneuvers, the deficits are noted and as well as possible (eg. As the number of squats or steps that have been climbed) quantified. Getting up from the crouch or climb on a chair proximal leg strength, heel or toe walking tests the distal force. push up when standing up from a chair with arms displays a quadriceps. Swinging of the body, to move the arms refers to a shoulder belt weakness. Getting up from the supine position by turning to prone, kneeling and use of hands to the thighs to a halt climb (Gower sign) suggests a pelvic girdle weakness.