Manual Muscle Testing: Trunk Flexion

Original Editor - Manali K Shah

Top Contributors - Lucinda hampton, Manali K Shah and Kim Jackson

Introduction

Trunk flexion has multiple elements that include cervical, thoracic, and lumbar motion. Measurement is difficult at best and may be done in a variety of ways with considerable variability in results.

The neck flexors should be eliminated as much as possible by asking the patient to maintain a neutral neck position with the chin pointed to the ceiling to avoid neck flexion.

Muscles involved:

• Rectus abdominis

• Obliquus externus abdominis
• Obliquus internus abdominis

Patient Positioning:

• For grade 5- supine with hands clasped behind head
• For grade 4- Supine with arms crossed over chest
• For grade 3- Supine with arms outstretched in full extension above plane of body
• For grade 0 to 2- Supine with arms at sides and knees flexed.

Therapist Position:

• Grade 3 to 5- Standing at side of table at level of patient's chest to be able to see whether scapulae clear table during test
• grade 0 to 2- Standing at side of table with the hand used for palpation is placed at the midline of the thorax over the linea alba, and the four fingers of both hands are used to palpate the rectus abdominis

To Test:

• For grade 3 to 5- Patient flexes trunk through complete range of motion. A curl-up is emphasized , and trunk is curled until scapulae clear table
• For grade 2- Ask the patient to lift the head from the table. If the scapulae do not clear the table, the Grade is 2.
• For grade 0 and 1- therapist uses assisted forward lean technique or coughing techique in same position, while palpating rectus abdominis.