Grading of muscle strength:
Grade
Strength
Description
5*
Normal
Normal strength
4*
Good
Movement against external resistance but less than normal
3
Fair
Movement against gravity but not against added resistance
2
Poor
Movement at the joint with gravity eliminated
1
Trace
Trace of contraction but no movement at the joint
0
Zero
No contraction or muscle movement
*The distinction between Grades 4 and 5 is based on comparison with the normal hand and, barring that, extensive experience in testing the hand.
Position of patient's hand and upper extremity
Examiner’s Actions
Instructions for the patient