Resisted Isometric Movement Testing

The Resisted Isometric Movement testing was an examination developed by Cyriax. It was originally called resisted movements, and is sometimes known as the resisted isometrics.

Contractile structures: Structures that possess the ability to contract and relax. Eg: muscle.

Inert structures: Structures in the human body that cannot shorten or elongate in length. Eg: ligaments, tendons, capsule, bursa.

If a joint is held at a mid range and the patient is asked to isometrically contract using a maximal effort, no strain would fall on the inert structures. For instance, if the patient

Procedure:

• The joint is positioned in mid range, keeping the inert tissues off of stretch and there must be no movement at the joint
• Muscles other than the testing muscles must not be included. Hence trick movements from surrounding muscles must be avoided.
• The patient must be instructed to exert a maximal effort during the test.
• Examiner must be attentive in identifying pain or weakness that would be due to a nerve involvement

Weakness: Minor weakness need to be detected with the hands well positioned to offer resistance and counter pressure.

Interpretation

Strong and painless: No lesion in the contractile structure

Strong and painful: Minor lesion in a part f the muscle or tendon and its attachment.

Weak and painless: There could be a complete rupture of the muscle or tendon, but most commonly might be a malfunction of the nerves. This impaired function of the nerve leads to muscle weakness.

Weak and painful: Serious impairment, like a secondary deposit or a fracture might be present. However, if a patient is reluctant to replicate the severe pain it may appear as apparent weakness

Painful on repetition: Intermittent claudication could be the reason a the movement is painless and strong initially but hurts on repetition.

All resisted movements painful: A gross lesion lying proximally, which would mostly be a capsular leision,