Which statement describes grade 4 in manual muscle testing?

• A. It represents active movement against gravity with added resistance.
• B. It represents active movement against gravity with no added resistance.
• C. It represents movement with gravity eliminated.
• D. It represents full ROM with resistance.

Answer: (A)

In manual muscle testing, the level described as active movement against gravity with added resistance shows that the muscle can move the limb through its full range while working against gravity and also withstand external force from the examiner. This indicates a good level of strength—stronger than movements against gravity with no resistance, but not maximal strength. It sits above the level where movement is only against gravity and below the level where you can maintain full ROM against maximum resistance. The other descriptions map to different levels: gravity-eliminated movement is a lower grade, and full ROM with maximal resistance is the highest grade.