During ASIA motor testing for elbow flexors (C5), the patient moves through full ROM against gravity but cannot tolerate moderate resistance. What is the muscle grade?

During ASIA motor testing for elbow flexors (C5), the patient moves through full ROM against gravity but cannot tolerate moderate resistance. What is the muscle grade?

• A. Grade 2
• B. Grade 4
• C. Grade 3
• D. Grade 5

Answer: (C)

In this scenario, the key idea is what the grading scale means for muscle strength during ASIA motor testing. Grade 3 corresponds to active movement of the joint against gravity without any added resistance. The elbow flexors at C5 (primarily the biceps brachii) can move the elbow through the full range when the limb must fight against gravity, but they cannot sustain or tolerate any additional resistance beyond that. If resistance were tolerated, you’d be at Grade 4, which indicates movement against gravity plus moderate resistance. If the movement were normal and could withstand maximal resistance, that would be Grade 5. Movement not possible against gravity would fall to Grade 2 or lower. So, moving through the full range against gravity but not tolerating moderate resistance aligns with Grade 3.

In this scenario, the key idea is what the grading scale means for muscle strength during ASIA motor testing. Grade 3 corresponds to active movement of the joint against gravity without any added resistance. The elbow flexors at C5 (primarily the biceps brachii) can move the elbow through the full range when the limb must fight against gravity, but they cannot sustain or tolerate any additional resistance beyond that.

If resistance were tolerated, you’d be at Grade 4, which indicates movement against gravity plus moderate resistance. If the movement were normal and could withstand maximal resistance, that would be Grade 5. Movement not possible against gravity would fall to Grade 2 or lower.

So, moving through the full range against gravity but not tolerating moderate resistance aligns with Grade 3.