Manual Muscle Testing: Elbow Flexion

Original Editor - Claire Knott

Top Contributors - Claire Knott and Wanda van Niekerk  

Muscles Involved:

Patient Positioning

  • Grades 2 to 5 testing - patient is seated
  • Grades 0 to 1 testing - patient is supine for 'gravity minimal' position
  • Hand positioning depends on specific muscle:
    • Biceps: supination
    • Brachialis: pronation
    • Brachioradialis: midposition

Therapist Position

  • Therapist at test side
  • Ensure wrist flexors are not contracting
  • Palpation over intended test muscle

To Test

  • Patient is to flex the elbow
  • Grades 4 and 5 with resistance over flexor surface at the distal forearm with force in the direction opposite to flexion.[1]
  • To satisfy grade 5 'normal muscle' performance criteria, the patient must have the ability to move through complete range of motion (active resistance testing) OR maintain an end point range (break testing) against maximum resistance.

References

  1. Hislop H, Avers D, Brown M. Daniels and Worthingham's muscle Testing-E-Book: Techniques of manual examination and performance testing. Elsevier Health Sciences; 2013 Sep 27.