Manual Muscle Testing: Wrist Flexion

Muscles Involved:

Flexor carpi radialis

Flexor carpi ulnaris

Patient Positioning

  • Patient is seated with dorsal surface of forearm supported on table in supination

Therapist Position

  • Therapist is seated to access test-side
  • Palpation of wrist flexors

To Test

  • Patient actively flexes the wrist through range.
  • For grades 4 to 5 apply resistance through palm in a direction opposite to flexion.
  • 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.

Biasing Muscles/ Muscle Groups

  • To bias flexor carpi ulnaris: instruct patient to flex wrist leading with 5th digit and apply resistance in the direction of radial deviation and extension over 5th metacarpal.
  • To bias flexor carpi radialis: instruct patient to flex wrist leading with the thumb and apply resistance in the direction of ulnar deviation and extension over 2nd metacarpal.[1]

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.