Manual muscle testing (MMT8), the standard for assessing muscle function in patients with idiopathic in ammatory myopathies, has faced considerable criticism. New research using a 3-pronged approach demonstrated that patient-performed functional tests are reliable, scalable options for MMT8, with gait analysis providing complementary insights.

Anna-Maria Liphardt, PhD, and colleagues aimed to compare MMT8 with inertial sensor-based gait analysis to evaluate patient-performed functional tests guided by shared decision-making and investigate adherence to electronic patient-reported outcomes (PROs) in a small cohort of individuals with idiopathic in ammatory myopathies. The findings were reported in Arthritis Research & Therapy.

The study included 28 patients (67.9% women; mean age, 57.4 years), with the majority (32.1%) diagnosed with antisynthetase syndrome. MMT8 was performed at baseline and 3 months.

In addition, inertial-sensor-based gait analysis was completed at baseline, and two standardized upper extremity (Modified Barré test, 10-time arm lift test) and two lower extremity muscle endurance tests (60-second Sit-to-Stand test, Mingazzini test) were offered as options for patients to select from. Through shared decision-making, each patient selected one test for lower and upper extremities and opted to record weekly results on paper or through a medical app.

The researchers analyzed correlations between gait parameters, functional tests, and MMT8 and assessed agreement between patient- and healthcare professional (HCP)–recorded results at baseline and 3 months.

They observed moderate correlations between MMT8 and gait parameters such as walking speed (r=0.545; P=0.004) and stride length (r=0.580; P=0.002). All patients selected the Modi ed Barré test for assessing upper extremity function, and 60.7% of patients chose the Mingazzini test for assessing lower extremity function.

The results showed excellent agreement between patient- and HCP-recorded functional test outcomes at baseline and 3-month follow-up assessments (ranging from 0.99 to 1.00), showing the reliability of self-assessment. Functional tests demonstrated strong correlations with MMT8, particularly for the Mingazzini test (r=0.762; P=0.002). Most patients (82.1%) preferred app based recording to paper-based recording, and weekly electronic PROs were completed, on average, for 6.9 of 12 weeks (57.1%).

The researchers noted that larger studies are warranted to establish the findings’ broader applicability and potential to improve patient self-management and clinical efficacy