PhysioHub

Resisted Isometric Testing of the Hand & Wrist

Source: Physiotutors

Execution

  1. 1Position the patient sitting with the wrist and forearm in neutral unless a specific painful position is being assessed.
  2. 2Resist forearm pronation and supination isometrically.
  3. 3Resist wrist flexion, extension, radial deviation, and ulnar deviation isometrically.
  4. 4Resist finger flexion, finger extension, finger abduction, finger adduction, and thumb movements when indicated by the complaint.
  5. 5Record pain, weakness, rupture signs, neurological pattern, and whether the response changes with wrist or finger position.

Positive outcome

Abnormal findings: pain, weakness, rupture signs, or a neurological pattern with contraction.

Interpretation
  • Pain with contraction: contractile-tissue involvement
  • Weakness without pain: rupture, neurological deficit, pain inhibition, or marked deconditioning
Clinical pearl

Many forearm muscles cross the wrist and hand, so the exact position of wrist, fingers, and forearm changes which tissue is loaded. Use this as an impairment screen to decide whether tendon, muscle, nerve, or joint testing should be prioritized.

CommentMagee lists resisted isometric movements after passive range and emphasizes testing in sitting. This is an impairment screen rather than a diagnostic special test. Use it to decide whether tendon, muscle, nerve, or joint testing should be prioritized.

Low Clinical Value

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