Execution
- 1Position the patient sitting and support the forearm and hand so the patient remains relaxed.
- 2Passively test forearm pronation and supination, then wrist flexion, extension, radial deviation, and ulnar deviation.
- 3Stabilize the forearm or carpal region as needed to isolate the movement being tested.
- 4Record pain, available range, end feel, crepitus, clunk, and whether the movement differs from the opposite side.
- 5Interpret passive restriction with the expected wrist capsular pattern and the active movement findings.
Positive outcome
Abnormal findings: painful passive range, asymmetry, abnormal end feel, crepitus, or restriction.
Expected end-feels- Pronation: tissue stretch
- Supination: tissue stretch
- Flexion: tissue stretch
- Extension: tissue stretch
- Radial deviation: bone-to-bone
- Ulnar deviation: bone-to-bone
Wrist capsular pattern: flexion and extension equally limited. Radioulnar joint pattern: pronation and supination equally limited. Dose overpressure carefully as hand or wrist pain is easily irritated.
CommentPROM separates patient-controlled limitation from passive joint, capsular, ligament, or soft-tissue restriction. Magee notes that hand or wrist pain can be irritated by passive testing, so the examiner should dose overpressure carefully. Passive findings do not diagnose a specific lesion without matching history and special-test findings.
Low Clinical Value