|
Motion |
Examiner Position |
Model Position |
Examiner Instruction |
Hand Placement |
Muscles Involved |
Possible Substitutions |
Things to Note |
|
Flexion |
Standing in front
of test shoulder of patient |
Short Sitting; hand
/ forearm Supinated, arms at side
Alternate Positions:
forearm in pronation (brachialis)
OR
forearm in midposition between supination and pronation (brachioradialis)
|
Passive ROM
have patient relax and the examiner causes the motion
Active ROM
examiner should demonstrate motion and then have examiner complete
motion
Resistive ROM
Patient should resist examiner's overpressure in extension and/or examiner
should resist patient as they move through flexion
|
Passive ROM
Stabilizing hand at superior shoulder, moving hand at dorsal surface
of wrist
Active ROM
Patient does motion; may need to stabilize postieror aspect of elbow
in examiner's hand
Resistive ROM
Stabilizing hand at superior shoulder, moving hand at palmar aspect of
wrist |
Biceos brachii
Brachialis
brachioradialia |
Wrist flexors -
maintain relaxed wrist so as to gain no assistance from strong wrist
flexors
|
There are three
main positions so as to attempt to isolate musculature; however, if strong
effort is used, it may be difficult to separate muscles |
| Extension |
Stand @ test side
Resistance applied just above elbow |
Prone with arms @ side; arm in
90 degrees abduction and forearm flexed and hanging vertically over the
side of the table
Alternate Position:
May be sitting with shoulder in neutral and elbow flexed 90 degrees
|
Passive ROM
have patient relax and the examiner causes the motion;
Active ROM
examiner should demonstrate motion and then have examiner complete
motion
Resistive ROM
Patient should resist examiner's overpressure in flexion and/or examiner
should resist patient as they move through extension
|
Passive ROM
Stabilizing hand over belly of biceps and other at palmar surface of
wrist
Active ROM
Patient causes motion
Resistive ROM
Stabilizing hand over belly of biceps and other at dorsal surface of wrist |
Ticeps brachii |
Watch for external rotation at
the shoulder as this may assist with extension by elbow falling into
extension
Watch for horizontal adduction of shoulder to assist
|
if you do elbow break test, make
sure that patient's elbow is in slight flexion so that the elbow will not
lock |
| Forearm Supination |
Standing on test side or in
front of patient |
Short sitting with arm at side,
elbow in 90 degrees flexion; forearm neutral or at mid position
Alternate Position:
Patient may sit at table with arm supported by table
|
Passive ROM
have patient relax and the examiner causes the motion
Active ROM
examiner should demonstrate motion and then have examiner complete
motion
Resistive ROM
Patient should resist examiner's overpressure in pronation and/or examiner
should resist patient as they move through supination
|
Passive ROM
One hand to stabilize elbow
Other hand at wrist to move patient into supination
Active ROM
Patient causes motion
Resistive ROM Resistance hand grasps forearm on
volar surface
Stabilizing hand at "cups" elbow for
support Alternate: If patient forearm is
supported by the table, the examiner may now use both hands to
"sandwich" the patient's hand to provide resistance through the
motion |
Biceps brachii
Supinator |
Wrist extensors may substitute
if patient does not fully relax the wrist and fingers |
Patient may externally rotate the
arm and adduct across the body to achieve supination with no activity of
supinator
|
| Forearm Pronation |
Standing on test side or in front
of patient |
Short sitting with arm at side,
elbow in 90 degrees flexion; forearm neutral or at mid position
Alternate Position:
Patient may sit at table with arm supported by table
|
Passive ROM
have patient relax and the examiner causes the motion
Active ROM
examiner should demonstrate motion and then have examiner complete
motion
Resistive ROM
Patient should resist examiner's overpressure in supination and/or examiner
should resist patient as they move through pronation
|
Passive ROM
One hand to stabilize elbow
Other hand at wrist to move patient into pronation
Active ROM
Patient causes motion
Resistive ROM
Resistance hand grasps forearm at wrist
Stabilizing hand at "cups" elbow for
support Alternate: If patient forearm is
supported by the table, the examiner may now use both hands to
"sandwich" the patient's hand to provide resistance through the
motion
|
Pronator teres
Pronator quadratus |
Watch for internal rotation and
abduction to roll arm with pronators involved |
Instruct patient to keep wrist
and fingers relaxed to avoid assistance form flexor carpi radialis and
finger flexors |
