Testing Positions Flashcards
Scapular Elevation
Against Gravity - Sitting, patient lifts the shoulder up, therapist resists on top of the shoulder in a downward direction.
Gravity Eliminated – Prone with arm down at side and supported at the shoulder by the therapist, patient lifts the shoulder up toward the ear, therapist resists on top of the shoulder in a parallel direction toward the feet.
Scapular Depression
Against Gravity - Prone, starting with the arm down at the side, patient lifts arm up over his head and then pulls the scapula down toward the hip (scapular depression). Therapist resists on the inferior angle in an upward direction toward the head.
Gravity Eliminated – prone, arm down at side and supported at the shoulder by the therapist. Patient reaches hand down toward the feet moving the scapula downward. Therapist resist on inferior angle in an upward direction toward the head.
Scapular Adduction/Retraction - Middle Trapezius
Against Gravity - Prone, the patient lifts the arm up into external rotation followed by scapular retraction (pulls scapula towards the vertebra). Therapist resists on the medial border in an outward direction.
Sitting, therapist supports shoulder into 90o of abduction followed by the patient attempting to pull the scapula toward the vertebra. Therapist applies resistance on the medial border in an outward direction.
Scapular Adduction/Retraction - Rhomboid Minor & Major
Against Gravity – Prone, patient places arm in small of back and then lifts arm up. Therapist resists on the medial border in an outward direction.
Gravity Eliminated – Sitting, therapist supports shoulder into 90o of abduction followed by the patient attempting to pull the scapula toward the vertebra. Therapist applies resistance on the medial border in an outward direction.
Scapular Abduction/Protraction
Against Gravity - Supine, patient lifts the shoulder to 90 degrees of shoulder flexion followed by scapular protraction (make sure the scapula rises up off the mat, elbow can be in extension or flexion). Therapist resists on the distal end of the humerus in a downward direction.
Gravity Eliminated – Sitting, therapist supports shoulder into 90o of flexion followed by the patient attempting to reach forward with the arm. Therapist resists on the distal end of the humerus in a backward direction.
Shoulder Flexion
Against Gravity - Sitting, patient assumes a position of 90o of shoulder flexion. Therapist resists on the distal end of the humerus in a downward direction toward extension.
Gravity Eliminated – Sidelying with the arm supported by the therapist, patient assumes a position of 90o of shoulder flexion. Resistance is applied to the distal end of the humerus in a parallel direction toward extension.
Shoulder Extension
Against Gravity – Prone or Sitting, starting with the arm down at the side, patient moves the arm backwards into shoulder extension. Therapist resists on the distal end of the humerus in a downward (if prone) or forward position (if sitting).
Gravity Eliminated – Sidelying with the arm supported by the therapist, patient assumes a position of shoulder extension. Resistance is applied to the distal end of the humerus in a parallel direction toward the starting position.
Shoulder Abduction
Against Gravity - Sitting, patient assumes a position of 90o of shoulder abduction. Therapist resists on the distal end of the humerus in a downward direction.
Gravity Eliminated – Supine with the therapist supporting the arm at the side in adduction, patient assumes a position of 90o abduction. Resistance is applied on the distal end of the humerus back toward adduction
Shoulder Horizontal Abduction
Against Gravity – Prone with the arm hanging over the edge of the plinth, the arm is abducted to 90o and the elbow is in 90o flexion. The patient lifts the elbow up toward the ceiling assuming a position of horizontal abduction. Resistance is applied on the distal end of the humerus in a downward direction.
Gravity Eliminated – Sitting with the arm supported by the therapist in a position of 90o of shoulder flexion, the patient moves the arm out to the side and back toward horizontal abduction. Resistance is applied on the distal end of the humerus back toward the starting position.
Shoulder Horizontal Adduction
Against Gravity – Supine with the arm in 90o of abduction the patient lifts the shoulder up and across the chest into shoulder horizontal adduction (can allow elbow flexion as the arm comes across the chest). Therapist resists on the distal end of the humerus in an outward direction toward horizontal abduction.
Gravity Eliminated – Sitting, therapist supports shoulder into 90o of abduction followed by the patient attempting to bring the arm across the chest into horizontal adduction. Therapist resists on the distal end of the humerus in an outward direction toward horizontal abduction.
Shoulder External Rotation
Against Gravity - Prone, with the humerus abducted to 90o and supported by the mat with the elbow flexed to 90o and hanging over the edge of the mat, the patient assumes a position of external rotation (back of the hand toward the ceiling) of the shoulder. Therapist resists proximal to the wrist in a downward direction.
Gravity Eliminated – Prone with the arm dangling off the edge of the mat in internal rotation (palm toward feet) the patient rotates the shoulder outward so that the palm is facing toward the head. Resistance is applied at the distal end of the humerus attempting to rotate the shoulder back to its starting position
Shoulder Internal Rotation
Against Gravity - Prone, with the humerus abducted to 90o and supported by the mat with the elbow flexed to 90o and hanging over the edge of the mat, the patient assumes a position of internal rotation of the shoulder (palm toward the ceiling). Therapist resists proximal to the wrist in a downward direction.
Gravity Eliminated – Prone with the arm dangling off the edge of the mat in external rotation (palm toward head) the patient rotates the shoulder inward so that the palm is facing toward the feet. Resistance is applied at the distal end of the humerus attempting to rotate the shoulder back to its starting position
Elbow Flexion
Against Gravity - Sitting, patient assumes a position of elbow flexion with the forearm in supination. The therapist resists proximal to the wrist in a downward direction.
Gravity Eliminated – Sitting with the arm supported by the therapist in 90o of shoulder abduction, forearm midposition (with the thumb up) and elbow extension. The patient flexes the elbow. Resistance is applied proximal to the wrist toward extension.
Elbow Extension
Against Gravity – (1) Sitting, patient places his hand on his head followed by straightening the elbow into extension. Pt is then asked to bend the elbow slightly (prevent locking of the elbow). Therapist resists proximal to the wrist in a downward direction toward elbow flexion. (2) Prone, humerus abducted to 90o and supported on plinth with forearm hanging over the edge. Patient straightens the elbow. Therapist resists with the elbow at 10-15o less than full extension so the elbow can not lock into a position of elbow extension. Resistance is applied proximal to the wrist in a downward direction (Fig 5-88, Trombly).
Gravity Eliminated – Sitting, with the arm supported by the therapist in 90o of shoulder abduction, forearm in midposition and elbow flexed. Patient extends the elbow (10-15o less than full extension). Therapist applies resistance proximal to the wrist toward flexion.
Forearm Pronation
Against Gravity – Sitting with the shoulder in adduction and the forearm in supination, patient assumes a position of forearm pronation palm down). Therapist resists proximal to the wrist attempting to turn the palm over toward supination.
Gravity Eliminated – Therapist supports the shoulder in 90o of flexion with the elbow in 90o of flexion and the forearm in supination. The patient turns palm away from face view toward pronation. Therapist resists proximal to the wrist attempting to turn the palm back toward supination.
Forearm Supination
Against Gravity – Sitting with the shoulder in adduction and the forearm in pronation, patient assumes a position of forearm supination palm up). Therapist resists proximal to the wrist attempting to turn the palm over toward pronation.
Gravity Eliminated – Therapist supports the shoulder in 90o of flexion with the elbow in 90o of flexion and the forearm in pronation. The patient turns palm toward the face view toward supination. Therapist resists proximal to the wrist attempting to turn the palm back toward pronation.
Wrist Extension
Against Gravity - Sitting, with the forearm resting on the table in pronation with the fingers relaxed in slight flexion, the patient lifts the wrist into extension. Therapist resists across the distal end of the metacarpals 2-5 in a downward direction (all 3 tested as a group).
Gravity Eliminated – Sitting, with the forearm resting on the table with the forearm in midposition and the fingers relaxed in slight flexion, the patient extends the wrist. Therapist resists across the distal end of the metacarpals 2-5 toward flexion.
Wrist Flexion
Against Gravity - Sitting, with the forearm resting on the table in supination with the fingers relaxed in slight flexion, the patient lifts the wrist into flexion. Therapist resists across the distal end of the metacarpals 2-5 in a downward direction (all 3 tested as a group).
Gravity Eliminated – Sitting, with the forearm resting on the table with the forearm in midposition and the fingers relaxed in slight flexion, the patient flexes the wrist. Therapist resists across the distal end of the metacarpals 2-5 toward extension.
Fingers MP Extension
Against Gravity - Sitting, with the forearm in pronation and supported on the table with the wrist in neutral and the fingers relaxed in flexion the patient lifts the MP joints of 2-5 into extension keeping the PIP and DIP joints relaxed in flexion. Therapist resists on proximal phalanx of digits 2-5 in a downward direction testing as a group (each proximal phalanx can also be tested individually if weakness is present).
Gravity Eliminated – Forearm supported in midposition by the therapist with the wrist in neutral and the fingers relaxed in flexion, the patient extends the MP joints of digits 2-5. Therapist resists on proximal phalanx of digits 2-5 toward flexion.
Finger PIP Flexion
Against Gravity – Forearm supinated and supported on the table with the fingers in extension. The patient flexes the PIP joint while the therapist stabilizes the proximal phalanx of the finger being tested and holds down all other fingers (each finger tested individually). The therapist applies resistance to the middle phalanx in a downward direction toward PIP extension (test digits 2-5 individually).
Gravity Eliminated – Forearm supported in midposition with the fingers in extension. Patient flexes the PIP joint of the finger being tested while the therapist stabilizes the proximal phalange of the tested finger as well as all other fingers so that all other joints remain in extension. Therapist applies resistance on the middle phalanx of the digit being tested
Finger DIP Flexion
Against Gravity – Forearm supinated and supported on the table with the fingers in extension. The patient flexes the DIP joint while the therapist stabilizes the middle phalanx of the finger being tested (each finger tested individually). The therapist applies resistance to the distal phalanx in a downward direction toward DIP extension (test digits 2-5 individually).
Gravity Eliminated – Forearm supported in midposition with the fingers in extension. Patient flexes the DIP joint of the finger being tested while the therapist stabilizes the middle phalange of the tested finger. Therapist applies resistance on the distal phalanx of the digit being tested
Finger MP (MCP) Flexion
Against Gravity – Sitting, forearm in supination followed by MCP flexion with PIP and DIP extension. Therapist resists on the proximal phalanx of digits 2-5 in a downward direction toward MCP extension and PIP flexion.
Gravity Eliminated – Sitting, forearm in midposition followed by MCP flexion with PIP and DIP extension. Therapist resists on the proximal phalanx of digits 2-5 toward extension.
Finger MP (MCP) Abduction
Against Gravity – forearm in midposition and resting on the ulnar side, therapist supports at the wrist while patient abducts digit 2 (DI -1), therapist resists on the head of the proximal phalanx (distal end) of digit 2 downward toward adduction, patient abducts digit 3 (DI -2), therapist resists on the head of the proximal phalanx (distal end) of digit 3 downward toward adduction, patient then turns and rests the hand on the radial side with the forearm in midposition, patient abducts digit 5 (ADM), therapist resists on the head of the proximal phalanx (distal end) of digit 5 downward toward adduction, then patient abducts digit 4 (DI-4), therapist resists on the head of the proximal phalanx (distal end) of digit 4 downward toward adduction, and finally patient abducts digit 3 (DI-3), therapist resists on the head of the proximal phalanx (distal end) of digit 3 downward toward adduction.
Gravity Eliminated – Sitting, with the forearm in pronation followed by abduction of the MCP’s of digits 2-5. Therapist resists on the head of the proximal phalanx of digit 2 on the radial side (DI-1), digit 3 on both sides on the head of the proximal phalanx (DI-2 on radial side; DI-3 on ulnar side), on digit 4 on the ulnar side on the head of the proximal phalanx (DI-4) and on digit 5 on the ulnar side on the head of the proximal phalanx (ADM) inward toward adduction.
MP (MCP) Adduction
Against Gravity – forearm in midposition resting on the ulnar side, therapist supports at the wrist (off of table) so that the fingers begin in abduction. Patient adducts digit 5 (PI -3), therapist resists on the head of the proximal phalanx of digit 5 downward toward abduction, patient adducts digit 4 (PI -2), therapist resists on the head of the proximal phalanx of digit 4 downward toward abduction, patient then turns and rests the hand on the radial side with the forearm in midposition and supported by the therapist at the wrist, patient begins with digit 2 (PI-1) in abduction and then moves into MCP adduction, therapist resists on the head of the proximal phalanx of digit 2 downward toward abduction.
Gravity-Eliminated - sitting with the forearm in pronation and MCP abduction. Patient adducts digits 2, 4 and 5. Therapist resists on the proximal phalanx of digits 2, 4 and 5 in an outward direction toward abduction.
Thumb IP Extension
Against Gravity – Sitting, starting with the forearm in midposition and IP joint of the thumb in flexion. Therapist stabilizes the proximal phalanx and the patient extends the IP joint of the thumb. Therapist resists on the distal phalanx in a downward direction toward IP flexion.
Gravity Eliminated – Starting with the forearm in supination and the IP joint in flexion, the therapist stabilizes the proximal phalanx and the patient extends the IP joint. Therapist resists on the distal phalanx toward IP flexion.
Thumb MP Extension
Against Gravity - Sitting, starting with the forearm in midposition and the MP joint of the thumb in flexion. Therapist stabilizes the first metacarpal and the patient extends the MP joint of the thumb. Therapist resists on the proximal phalanx in a downward direction toward MP flexion (not necessary that the IP joint remain flexed as stated on.
Gravity Eliminated – Starting with the forearm in supination and MP joint of the thumb in flexion, the therapist stabilizes the metacarpal and the patient extends the MP joint. Therapist resists on the proximal phalanx toward MP flexion.
Thumb CMC Palmar Abduction
Against Gravity - Sitting with the forearm in supination followed by CMC palmar abduction of the thumb. Therapist stabilizes at the metacarpal and resists on the proximal phalanx in a downward direction toward adduction.
Gravity Eliminated – Sitting, with the forearm resting on the table in midposition and the thumb in adduction, the therapist stabilizes the metacarpal and the patient moves the thumb away from the palm. Therapist resists on the proximal phalanx toward adduction.
Thumb IP Flexion
Against Gravity - Sitting with the elbow flexed and resting on the table (hand raised upward) with the forearm in supination and turned so that the anterior surface of the thumb is facing the ceiling and the MP and IP joints are in extension. The patient flexes the IP joint. Therapist stabilizes the proximal phalanx and resists on the distal phalanx in a downward direction toward extension.
Gravity Eliminated – forearm in supination with the MP and IP joints of the thumb in extension. The patient flexes the IP joint of the thumb while the therapist stabilizes the proximal phalanx. Resistance is applied on the distal phalanx toward extension.
Thumb MP Flexion
Against Gravity - Sitting with the elbow flexed and resting on the table (hand raised upward) with the forearm in supination and turned so that the anterior surface of the thumb is facing the ceiling and the MP and IP joints are in extension. The patient flexes the MP joint keeping the IP joint in extension. Therapist stabilizes the metacarpal and resists on the proximal phalanx toward MP extension.
Gravity Eliminated – forearm in supination with the MP and IP joints of the thumb in extension. The patient flexes the MP joint of the thumb across the palm of the hand while the therapist stabilizes the metacarpal. Resistance is applied on the proximal phalanx toward extension.
Thumb CMC Adduction
Against Gravity – Sitting, starting with the forearm in pronation and the thumb relaxed in abduction the patient lifts the thumb up under the index finger toward CMC adduction. Therapist resists on the proximal phalanx in a downward direction toward abduction.
Gravity Eliminated – Forearm in midposition and thumb in abduction, the patient moves the thumb toward CMC adduction. Therapist resists on the proximal phalanx attempting to pull the thumb away from the index finger.
Thumb CMC Opposition
Against Gravity – Sitting with the forearm in supination followed by thumb opposition to the 5th digit. Therapist stabilizes at the wrist and resists on the distal end of metacarpal 1 in an outward direction.
Gravity Eliminated – Elbow resting on the table with hand raised up and the wrist supported by the therapist. Patient opposes the thumb toward the 5th digit moving in a horizontal direction until the pads of each finger touch. Therapist resists on the distal end of metacarpal 1 in an outward direction.
5th Digit Opposition
Against Gravity – Sitting with the forearm in supination followed by 5th digit opposition to the thumb. Therapist stabilizes at the wrist and resists on the distal end of metacarpal 5 in an outward direction.
Gravity Eliminated – Elbow resting on the table with hand raised up and the wrist supported by the therapist. Patient opposes the 5th digit toward the thumb moving in a horizontal direction until the pads of each finger touch. Therapist resists on the distal end of metacarpal 5 in an outward direction.
