There are two sets of scores, usually recorded in tables, that you may see on your children’s clinic notes. If you are not sure what these mean please have a chat to your child’s physiotherapists who examine them and they will explain in more detail. You can also read on to find out a bit more about what they mean.
The North Star Ambulatory Assessment NSAA is a 17-item scale that grades performance of various functional skills on a scale from 0 (unable), 1 (completes independently but with modifications), and 2 (completed without compensation). It is usually used to monitor the progression of the disease and treatment effects in ambulant children with Duchenne muscular dystrophy.
The ‘Oxford Scale’ (AKA Medical Research Council Manual Muscle Testing scale) is the commonly accepted method of evaluating muscle strength. This method involves testing key muscles from the upper and lower extremities against the examiner’s resistance and grading the patient’s strength on a 0 to 5 scale accordingly. Sometimes a + or – sign is used to indicate more or less power but not sufficient to reduce or increase the number.
Oxford Scale
0/5 No contraction
1/5 Visible/palpable muscle contraction but no movement
2/5 Movement with gravity eliminated
3/5 Movement against gravity only
4/5 Movement against gravity with some resistance
5/5 Movement against gravity with full resistance
Watch Lisa Kerry, a Chartered Physiotherapist, explain the Oxford Scale in more detail.