VALIDATION DATA

MEASUREMENT PROPERTIES
Limitations
Observations
1. RELIABILITY
A. Internal Consistency Not Tested
Cronbach's (Describe)
B. Reliability intraobserver or test-retest Tested
Continuous scores: intraclass
correlation coefficient (ICC)
Dichotomus: Cohen kappa (Describe)

The levels of agreement attained, based upon +/- one grade were high, range from 96% to 98% for test-retest reliability.

C. Reliability interobserver or Measurement error Tested
Standard error of measurement (SEM),
smallest detectable change (SDC) or
Limits of agreement (LoA) (Describe)

A Rasch analysis performed to investigate physicians’ ability to discriminate among the MRC-5 scale categories demonstrated a poor inter-individual reproducibility since physicians have limited discriminating abilities in this 5-grade system

The levels of agreement attained, based upon +/- one grade were high, from 82% to 97% agreement for interexaminer reliability. 

2. VALIDITY
A. Content validity: face validity Tested
Expert opinion (relevance and
comprehensiveness) (Describe)

The MRC scale was developed by British physicians during World War II to grade strength after injuries. It was expanded and adapted to neuromuscular research in the 1970s.

B. Construct Validity:
Structural validity
Tested
Hypotheses-testing Not Tested
Cross-cultural validity Not Tested
Brief Description

There have been a number of papers that have specifically described the validity of MRC-MMT in relationship to patients with low back pain. The correlation between "inhibited" or "weak" MRC findings and low back pain has been well established in the research literature. 

C. Criterion validity Tested
Comparison with a 'gold standard' Continuous scores:
correlations, ROC curves Dichotomus:
Sensitivity & Specificity (Describe)

Marino et al (1982)  and Wadsworth et al (1987) showed significant reliability between handheld dynamometers and MRC-MMT. Scores measured with the dynamometers were consistent with the examiner's perception of muscle weakness (P less than 0.001) in both studies.