Manual Muscle Testing: Forearm Pronation

Original Editor - Kakshya Rupakheti Top Contributors - Kakshya Rupakheti

Muscle Involved

Pronator Teres

Pronator Quadratus

Patient Position

Grade 3 to 5  : Short sitting, arm at side, elbow flexed to 90°and forearm is positioned in supination.

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 Dorsal 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 Supination patient begins to pronate until the palm faces downward. The resistance motion applied by the therapist is in the direction of Supination. To test Grade 3 no resistance is given, for Grade 4 minimum resistance is given and for 5 maximum resistance is given.

Complete available range of motion and hold maximum resistance for grade 5. Complete available range of motion and hold moderate to minimum resistance for grade 4. Complete available range of motion without resistance.For grade 2 Instruct patient to pronate the forearm in the given position.

For Grade 1 palpate the pronator teres over the upper third of the volar surface of the forearm on a diagonal line from the medial condyle of the humerus to the lateral border of the radius. No limb movement is seen but contractile activity is present.

If there is no contractile activity then the grade is 0.[1]

[2]

Resources

  1. Hislop HJ.Daniels and Worthingham's Muscle testing: techniques of Manual Examination. St.Louis,Missouri. Saunders Elsevier,8th edition.
  2. EducatedPT. Forearm Pronation MMT. https://www.youtube.com/watch?v=ScRXwYwLl-U [last accessed 08/11/2020]