Scot Morrison - Upgrade your manual muscle test. How to measure strength in clinical practice, minimise error and interpret your findings.

My guest this week is Scot Morrison. Scot is a board certified orthopaedic physical therapist and certified strength coach. In this conversation, Scot summarises six steps for measuring strength in clinical practice. You will learn the importance of accepting uncertainty in measurement, how to minimise error with a standardised testing routine and the importance of interpreting test findings to the person being tested.  This is a discussion aimed at health professionals. Always seek the guidance of a qualified health professional with any questions you may have regarding your health or a medical condition. In this conversation: 0:00 About this episode 0:19 About Scot, welcome to Physio Foundations 1:39 Scot’s work so far – strength coaching, physical therapy, high performance, management, education and research 3:55 Why are you interested in measuring strength in the clinic? 6:00 What is strength, how do you define it? 7:10 The importance of being reliable when measuring strength 7:44 It’s better to say ‘I don’t know’ than to not know and guess 8:40 If strength matters, measure it properly 10:00 It’s your job to interpret strength testing results to that individual 10:40 Example of measuring knee extensor strength after ACL reconstruction 11:45 Step 1 – is this measure meaningful right now? Can you test strength without pain? 12:25 Step 2 - does the device measure in meaningful units (Newtons) 13:05 Step 3 – does the device have the ability to measure force at the rate you require? 13:30 Step 4 – set the test up properly. Proper fixation of the patient and device 15:45 Step 5 - The line of pull must be 90 degrees to the moment arm 16:15 Step 6 – Standardised approach to testing, warm up, instructions, 30 sec- 1 minute rest between efforts, standardised cueing, be consistent 19:15 Realise that there is uncertainty in measurement 21:03 Torque calculator on Scot’s website. Upgrade your manual muscle test 21:45 Why is it important to consider torque and body weight normalised torque? 24:45 Testing strength with a device doesn’t add more work and time 27:35 Limits of the Oxford scale. Can they lift their limb against gravity 28:12 What devices are most useful for measuring strength in the clinic? 31:45 Scot’s PhD – are we testing strength and are we testing it well. What is meaningful change? 35:20 Scot’s final thoughts. Realise we are dealing with uncertainty and need to make decisions under uncertainty 37:48 Scot Morrison PT is not the Australian PM! Angry Tweets from Australians… Funny. 39:11 Support this podcast by sharing it   Listen to Scot discuss strength assessment with Luke on the @MonashMRU podcast: https://podcasts.apple.com/au/podcast/how-to-measure-strength-in-your-clinical-practice-with/id1549298610?i=1000558331646 Find out more about Scot here:  physiopraxis.co/about Scot’s Therapeutic Exercise database: physiopraxis.co/physiotherexdatabase Scot’s torque calculator: physiopraxis.co/torque-calculation-app   Scot mentioned the TinDeq dynamometer: tindeq.com He also mentioned the JLW dynamometer: https://jlwforce.com/products/praxis-3-500 He also mentioned dynamometer systems by Hawkin Dynamics https://www.hawkindynamics.com/ …and Vald Health: https://valdhealth.com/dynamo/ Scot and I have no conflicts of interest and receive no money or benefits from these companies, we are simply interested in equipment for measuring strength Follow Scot on Twitter: twitter.com/scotmorrsn Follow Scot on Instagram: instagram.com/physio_praxis Follow and subscribe to Physio Foundations on your favourite podcast app. Join the conversation in the YouTube comments or via social media @PerratonPhysio For a list of episodes, transcripts and associated blogs, visit perraton.physio/physiofoundations   Follow @PerratonPhysio on Facebook, Twitter, Instagram and Linked In. Share this episode and tag me in @lukeperraton Do you have a topic you would like me to cover on the podcast? Email me: [email protected] Always seek the guidance of a qualified health professional with any questions you may have regarding your health or a medical condition.