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Test: Thumb IP Extension Tests
Video Link
Background/Purpose
Grade 5 (Normal), Grade 4 (Good), and Grade 3 (Fair)
Position of patient: forearm in midposition, wrist in neutral with ulnar side of hand resting on the exam table. Thumb relaxed in a flexion posture.
Position of examiner: Use the table to support the ulnar side of the hand and stabilize the proximal phalanx of the thumb. Apply resistance over the dorsal surface of the distal phalanx of the thumb in the direction of flexion.
Procedure
Test: Patient extends the IP joint of the thumb.
Instructions to patient: “Straighten the end of your thumb.†Hold it. Don’t let me push it down.â€
Performed: Unilaterally
Dialog
Grade 5 (Normal) and Grade 4 (Good): Completes full range of motion. This is not a strong muscle, so resistance must be applied accordingly. The distinction between Grades 5 and 4 is based on comparison with the contralateral normal hand and, barring that, extensive experience in testing the hand.Criteria
- Grade 3 (Fair): Completes full range of motion with no resistance.
- Grade 2 (Poor), Grade 1 (Trace), and Grade 0 (Zero) Position of patient: forearm in pronation with wrist in neutral and thumb in relaxed flexion posture to start. Position of examiner: stabilize the wrist over its dorsal surface. Stabilize the fingers by gently placing the other hand across the fingers just below the MP joints. Test: patient extends distal joint of the thumb. Instructions to patient: “Straighten the end of your thumb.â€
- Grade 2 (Poor): Thumb completes partial range of motion.
- Grade 1 (Trace): Palpate the tendon of the Extensor pollicis longus on the ulnar side of the anatomic snuff box or, alternatively, on the dorsal surface of the proximal phalanx.
Measurement
LOINC Code
0Scale/Grading
selection range; grade - LOINC IDTest Stats
-
Side Pass Fail Left 0 0 Right 0 0 Avg. Measure. Left 0.0 0.0 Avg. Measure. - Right 0.0 0.0