Daniels and Worthingham's Muscle Testing: Techniques of Manual Examination, 6th ed.

Hislop HJ, Montgomery J. Philadelphia, PA 19106, WB Saunders Co, 1995, paperback, 437 pp, $38.

The purpose of this book, according to the authors, is to present "tried and true methods for assessing and grading skeletal muscle function." The book is not intended to address the rationale of such testing or to describe the many alternatives (manual or instrumented) to the methods presented. A major and sound assumption underlying the procedures described in the book is that muscle testing cannot quantify the strength of specific muscles. The testing can only document the strength of muscle actions across joints.

The book is organized into an introduction and nine chapters. A short chapter on the principles of manual muscle testing is presented first. Separate chapters focus on the testing of the muscles of the neck trunk, upper-extremity regions, and lower-extremity regions. Thereafter, chapters on the testing of infants and children, muscles innervated by the cranial nerves, and upright motor control are presented. The book concludes with a reference chapter. The chapters on testing specific muscle regions of the body are presented systematically. The test of each action is illustrated by line drawings. Further illustrations of the prime mover muscles, their orientation, and the innervation of the prime movers supplement the descriptions of the test procedures. References are provided for the individual chapters and at the end of the book.

In revising the book for this most recent edition, the authors have retained the best of previous editions while assiduously incorporating important new material. An example of note is the alteration of the grades for ankle planter flexion based on the number of repetitions of toe raising that healthy individuals can actually complete. Specifically, the book now calls for the completion of at least 20 toe raises to receive a grade of 5.

The book represents an ideal balance of science and practice. I believe that it is the best overall muscle testing book for use with entry-level curricula and a useful addition to the library of seasoned clinicians.

Richard W Bohannon, EdD, PT, NCS University of Connecticut Storrs, Conn

Dr Bohannon is Professor in the physical therapy program at The University of Connecticut. He is also the author of over 50 papers relevant to stroke and rehabilitation and an editorial board member of several journals concerned with stroke rehabilitation.