Manual Muscle Testing of the Fingers

Cervical Spine Fingers (MCP, PIP, & DIP Joints) Knee
Glenohumeral Joint Thumb (CMC, MCP, & IP Joints) Ankle
Elbow & Radioulnar Joints Lumbar & Thoracic Spine Scapulothoracic
Wrist Hip Toes (MTP, PIP, & DIP Joints)
Motion Patient Position Start Position End Position
MCP Flexion The patient is sitting or supine with forearm in supination. The wrist is in neutral with the MCP joints fully extended. The therapist stabilizes the metacarpals just proximal to the MCP joint, and applies resistance on the palmer surface of the proximal row of phalanges in the direction of MCP extension while the patient flexes at the MCP joint.  
MCP Extension The patient's forearm is in pronation with the wrist in neutral. MP joints and IP joints are in relaxed flexion posture. Therapist stabilizes the wrist and places the index finger of the resistance hand across the dorsum of all proximal phalanges just distal to the MCP joints. Give resistance in the direction of flexion.  
PIP Flexion The patient's forearm is in supination with the wrist in neutral. The finger to be tested is in slight flexion at the MCP joint. The therapist holds all fingers, except the test finger, in extension at all joints. The therapist applies resistance at the head of the middle phalanx in the direction of extension while the patient actively flexes the PIP joint.  
PIP Extension  The patient's forearm is in pronation with the wrist in neutral. The finger being tested should be in slight extension at the MCP joint. The patient's other fingers are flexed against the table, except the test finger. The therapist stabilizes the test finger at the proximal phalanx. The therapist applies resistance distal to PIP joint in the direction of flexion, while the patient extends the PIP joint.
DIP Flexion The patient's forearm is in supination with the wrist in neutral, with the PIP joint in extension. The therapist stabilizes the middle phalanx by grasping it on either side, and resistance is applied at the distal phalanx in the direction of extension while the patient actively flexes the DIP joint.  
DIP Extension  The patient's forearm is in pronation with the wrist in neutral. The finger being tested should be in slight extension at the PIP joint. The patient's other fingers are flexed against the table, except the test finger. The therapist stabilizes the test finger at the middle phalanx. The therapist applies resistance distal to DIP joint in the direction of flexion, while the patient extends the DIP joint.
Finger Abduction The patient's forearm is pronated with the wrist in neutral. Fingers start in extension and adduction. MCP joints are in neutral while avoiding hyperextension. Therapist supports wrist in neutral. The fingers of the other hand are used to give resistance on the distal phalanx, on the radial side of one finger and the ulnar side of the adjacent finger. The direction of resistance is toward adduction while patient actively abducts.
Finger Adduction The patient's forearm is pronated, wrist in neutral, and fingers extended and abducted. The therapist supports the wrist in neutral. The fingers of the other hand are used to give resistance on the distal phalanx, on the radial side of one finger and the ulnar side of the adjacent finger. The direction of resistance is toward abduction while the patient actively adducts.

Adapted from:

Hislop, Helen J. & Montgomery, Jaqueline with contributor Barbara Connelly.

      Daniels and Worthingham's muscle testing: techniques of manual examination., 6th edition, 1995.