Test: Hip Adduction (Adductors magnus, brevis and longus; Pectineu

Video Link

Background/Purpose

Grade 5 (Normal), Grade 4 (Good), and Grade 3 (Fair)
Position of patient: With patient side-lying with test limb resting on the table and uppermost limb in 25 degree of abduction, supported by clinician. The clinician cradles the leg with the forearm, the hand supporting the limb on the medial surface of the knee.
Position of clinician: Standing behind the patient at knee level with the hand giving resistance to the test limb. The hand is placed on the medial surface of the distal femur, just proximal to the knee joint. Resistance is directed straight downward toward the table.

Instructions to the patient: “Lift your bottom leg up to your top one. Hold it. Don’t let me push it down.” For Grade 3: “Lift your bottom leg up to your top one. Don’t let it drop!”
Grade 2 (Poor)
Position of patient: Supine. The nontest limb is positioned in the same abduction to prevent interference with motion of the test limb.
Position of clinician: Standing at side of test limb at knee level. One hand supports the ankle and elevates it slightly from the exam table surface to decrease friction as the limb moves across. The clinician uses the hand neither to assist nor resist the motion. The opposite hand palpates the adductor mass on the inner aspect of the proximal thigh.

Instructions to patient: “Bring your leg in toward the other one.”


Grade 1 (Trace) and Grade 0 (Zero)
Position of patient: Supine.
Position of clinician: Standing on the side of the test limb. One hand supports the limb under the ankle. The other hand palpates the adductor mass on the proximal medial thigh.

Instructions to patient: “Try to bring your leg in.”

Procedure

Test for Grade 5, 4, and 3: The patient adducts the hip until the lower limb contacts the upper one.

Test for Grade 2: The patient adducts hip without rotation.

Test for Grade 1 and 0: The patient attempts to adduct hip.
Performed: Unilaterally

Dialog

In the supine position for Grades 2, 1, and 0 the weight of the opposite leg stabilizes the pelvis, so there is no need for manual stabilization of the hip not being tested.

Criteria

• Grade 5 (Normal) Completes full range; holds end position against maximal resistance.
• Grade 4 (Good) Completes full movement; but tolerates strong to moderate resistance.
• Grade 3 (Fair) Completes full movement; holds end position but takes no resistance.
• Grade 2 (Poor) Patient adducts limb through full range.

Measurement

LOINC Code

0

Scale/Grading

Pass/Fail