Manual Muscle Testing: Forearm Supination

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Muscles Involve

Supinator

Biceps Brachii

Patient Position

Grade 3 to 5  : Short sitting, arm at side, elbow flexed to 90°.

Grade 2: Short sitting with shoulder flexed between 45° and 90° and elbow flexed to 90°, forearm in a neutral position.

Grade 1 and 0 : Short sitting, arm and elbow are flexed as for grade 3.

Therapist Position

Grade 3 to 5 : Stand at the side or in front of the patient. One hand supports the patient elbow and for resistance, grasp the forearm on the volar surface of the wrist.

Grade 2: Support the test arm by cupping the hand under the elbow.

Grade 1 and 0: Support the forearm just distal to the elbow.

To Test

The instruction to the patient should be given in the language which the patients understand more clearly.

From the pronation patient begins to supinate until the palm faces the ceiling. The resistance motion applied by the therapist is in the direction of Pronation. To test Grade 3 no resistance is given, for Grade 4 minimum resistance is given and for 5 maximum resistance is given.

Patient supinate the forearm through partial range of motion in the above given patient postion.

For Grade 1 palpate the supinator muscle distal to the head of the radius on the dorsal aspect of the forearm. No limb movement is seen but contractile activity is present.

If there is no contractile activity then the grade is 0.