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MRC muscle strength sum score

Adds strength of 6 groups on each side (0 to 5 each). Used in ICU-acquired weakness diagnosis and Guillain–Barré follow-up.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

MRC sum score/Kleyweg 1991: 6 bilateral groups 0–5, total 0–60

A sum of manual strength assessments in a patient who can be examined. ICU studies involved specific recruitment conditions, which are not universal restrictions on MRC. The strength sum must not be confused with an etiological diagnosis or a global disability scale.

Required fields: 0/12 completed

Complete all required fields. Optional fields are marked.

Shoulder abduction – right required

Shoulder abduction – left required

Elbow flexion – right required

Elbow flexion – left required

Wrist extension – right required

Wrist extension – left required

Hip flexion – right required

Hip flexion – left required

Knee extension – right required

Knee extension – left required

Ankle dorsiflexion – right required

Ankle dorsiflexion – left required

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Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Shoulder abduction – right
Shoulder abduction – left
Elbow flexion – right
Elbow flexion – left
Wrist extension – right
Wrist extension – left
Hip flexion – right
Hip flexion – left
Knee extension – right
Knee extension – left
Ankle dorsiflexion – right
Ankle dorsiflexion – left

5/5 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

MRC per group: 0 no contraction · 1 visible contraction without movement · 2 active movement with gravity eliminated · 3 overcomes gravity · 4 overcomes gravity and some resistance · 5 normal strength.

Sum 6 bilateral groups: shoulder abduction, elbow flexion, wrist extension, hip flexion, knee extension, ankle dorsiflexion. Total 0 to 60.

References

Identifier: escore-mrc

Original clinical content: Brazilian Portuguese.

Method version

MRC sum score/Kleyweg 1991: 6 bilateral groups 0–5, total 0–60

escore-mrc@native-2026-10-03+1cc2c29989e9

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (5)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Shoulder abduction – right: 5 – Normal strength
Shoulder abduction – left: 5 – Normal strength
Elbow flexion – right: 5 – Normal strength
Elbow flexion – left: 5 – Normal strength
Wrist extension – right: 5 – Normal strength
Wrist extension – left: 5 – Normal strength
Hip flexion – right: 5 – Normal strength
Hip flexion – left: 5 – Normal strength
Knee extension – right: 5 – Normal strength
Knee extension – left: 5 – Normal strength
Ankle dorsiflexion – right: 5 – Normal strength
Ankle dorsiflexion – left: 5 – Normal strength

{
  "ombro_d": "5",
  "ombro_e": "5",
  "cotovelo_d": "5",
  "cotovelo_e": "5",
  "punho_d": "5",
  "punho_e": "5",
  "quadril_d": "5",
  "quadril_e": "5",
  "joelho_d": "5",
  "joelho_e": "5",
  "tornozelo_d": "5",
  "tornozelo_e": "5"
}

Expected result

{
  "score": 60,
  "level": "low"
}

Actual result

{
  "score": 60
}

Case 2

reference-002

Inputs

Shoulder abduction – right: 4 – Movement against gravity and some resistance
Shoulder abduction – left: 4 – Movement against gravity and some resistance
Elbow flexion – right: 4 – Movement against gravity and some resistance
Elbow flexion – left: 4 – Movement against gravity and some resistance
Wrist extension – right: 4 – Movement against gravity and some resistance
Wrist extension – left: 4 – Movement against gravity and some resistance
Hip flexion – right: 4 – Movement against gravity and some resistance
Hip flexion – left: 4 – Movement against gravity and some resistance
Knee extension – right: 4 – Movement against gravity and some resistance
Knee extension – left: 4 – Movement against gravity and some resistance
Ankle dorsiflexion – right: 4 – Movement against gravity and some resistance
Ankle dorsiflexion – left: 4 – Movement against gravity and some resistance

{
  "ombro_d": "4",
  "ombro_e": "4",
  "cotovelo_d": "4",
  "cotovelo_e": "4",
  "punho_d": "4",
  "punho_e": "4",
  "quadril_d": "4",
  "quadril_e": "4",
  "joelho_d": "4",
  "joelho_e": "4",
  "tornozelo_d": "4",
  "tornozelo_e": "4"
}

Expected result

{
  "score": 48,
  "level": "low"
}

Actual result

{
  "score": 48
}

Case 3

reference-003

Inputs

Shoulder abduction – right: 4 – Movement against gravity and some resistance
Shoulder abduction – left: 4 – Movement against gravity and some resistance
Elbow flexion – right: 4 – Movement against gravity and some resistance
Elbow flexion – left: 4 – Movement against gravity and some resistance
Wrist extension – right: 4 – Movement against gravity and some resistance
Wrist extension – left: 4 – Movement against gravity and some resistance
Hip flexion – right: 3 – Movement against gravity, without resistance
Hip flexion – left: 3 – Movement against gravity, without resistance
Knee extension – right: 3 – Movement against gravity, without resistance
Knee extension – left: 3 – Movement against gravity, without resistance
Ankle dorsiflexion – right: 3 – Movement against gravity, without resistance
Ankle dorsiflexion – left: 3 – Movement against gravity, without resistance

{
  "ombro_d": "4",
  "ombro_e": "4",
  "cotovelo_d": "4",
  "cotovelo_e": "4",
  "punho_d": "4",
  "punho_e": "4",
  "quadril_d": "3",
  "quadril_e": "3",
  "joelho_d": "3",
  "joelho_e": "3",
  "tornozelo_d": "3",
  "tornozelo_e": "3"
}

Expected result

{
  "score": 42,
  "level": "mid"
}

Actual result

{
  "score": 42
}

Case 4

reference-004

Inputs

Shoulder abduction – right: 3 – Movement against gravity, without resistance
Shoulder abduction – left: 3 – Movement against gravity, without resistance
Elbow flexion – right: 3 – Movement against gravity, without resistance
Elbow flexion – left: 3 – Movement against gravity, without resistance
Wrist extension – right: 3 – Movement against gravity, without resistance
Wrist extension – left: 3 – Movement against gravity, without resistance
Hip flexion – right: 3 – Movement against gravity, without resistance
Hip flexion – left: 3 – Movement against gravity, without resistance
Knee extension – right: 3 – Movement against gravity, without resistance
Knee extension – left: 3 – Movement against gravity, without resistance
Ankle dorsiflexion – right: 3 – Movement against gravity, without resistance
Ankle dorsiflexion – left: 3 – Movement against gravity, without resistance

{
  "ombro_d": "3",
  "ombro_e": "3",
  "cotovelo_d": "3",
  "cotovelo_e": "3",
  "punho_d": "3",
  "punho_e": "3",
  "quadril_d": "3",
  "quadril_e": "3",
  "joelho_d": "3",
  "joelho_e": "3",
  "tornozelo_d": "3",
  "tornozelo_e": "3"
}

Expected result

{
  "score": 36,
  "level": "mid"
}

Actual result

{
  "score": 36
}

Case 5

reference-005

Inputs

Shoulder abduction – right: 2 – Active movement with gravity eliminated
Shoulder abduction – left: 2 – Active movement with gravity eliminated
Elbow flexion – right: 2 – Active movement with gravity eliminated
Elbow flexion – left: 2 – Active movement with gravity eliminated
Wrist extension – right: 2 – Active movement with gravity eliminated
Wrist extension – left: 2 – Active movement with gravity eliminated
Hip flexion – right: 2 – Active movement with gravity eliminated
Hip flexion – left: 2 – Active movement with gravity eliminated
Knee extension – right: 2 – Active movement with gravity eliminated
Knee extension – left: 2 – Active movement with gravity eliminated
Ankle dorsiflexion – right: 2 – Active movement with gravity eliminated
Ankle dorsiflexion – left: 2 – Active movement with gravity eliminated

{
  "ombro_d": "2",
  "ombro_e": "2",
  "cotovelo_d": "2",
  "cotovelo_e": "2",
  "punho_d": "2",
  "punho_e": "2",
  "quadril_d": "2",
  "quadril_e": "2",
  "joelho_d": "2",
  "joelho_e": "2",
  "tornozelo_d": "2",
  "tornozelo_e": "2"
}

Expected result

{
  "score": 24,
  "level": "high"
}

Actual result

{
  "score": 24
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.