Rick was wearing a neck brace because of neck instability in the early phases of rehabilitation. During this time you were asked to do a manual muscle test of the upper extremities. What should you do?

A. Perform manual muscle test, following standard procedures for all movements.
B. Test forearms and hands only.
C. Test shoulders, forearms, and hands, forgoing resistance at end of motion while following the shoulder protocols.
D. Defer the test until the brace is removed.

ANS: C
Manual muscle testing standard procedures require providing resistance at the end of the client's active ROM if muscle grades are fair plus and above; in the early phase of rehabilitation, when the neck is healing, resistance applied to shoulder muscles can cause undue stress on the neck. It is, however, important in the early stages for the occupational therapist to adequately assess the potential muscle strength in the shoulder to determine intervention possibilities, which can usual-ly be accomplished without following the manual muscle testing protocols to the letter. The fore-arms and hands can be tested using manual muscle testing protocols without stressing the neck.