Test: Forearm Pronation

Video Link

Background/Purpose

Grade 5 (Normal), Grade 4 (Good), and Grade 3 (Fair)
Position of patient: Short sitting or may sit at an exam table. Arm at side with elbow flexed at 90 degree and forearm in neutral.
Position of examiner: Standing at side or in front of patient. Support the elbow. Hand used for resistance grasps the forearm over the dorsal surface at the wrist.

Procedure

Test: Patient begins with a neutral forearm position and pronates the forearm until the palm faces downward. Examiner resists motion at the wrist in the direction of supination for Grades 4 and 5. (No resistance is given for Grade 3). Alternative test: Grasp patient’s hand as if to shake hands, cradling the elbow with the other hand and resisting pronation via the hand grip. This alternate test may be used if the patient has normal or good wrist and hand strength.
Performed: Unilaterally

Dialog

Instructions to patient: “Turn your palm down. Hold it. Don’t let me turn it up. Keep your wrist and fingers relaxed.”

Criteria

• Grade 5 (Normal): Completes available range of motion and holds against maximal resistance.
• Grade 4 (Good): Completes all available range against strong to moderate resistance.
• Grade 3 (Fair): Completes available range without resistance.
• Grade 2 (Poor) Position of patient: short sitting with shoulder flexed between 45 and 90 degrees and elbow flexed to 90 degrees. Forearm in neutral. Position of examiner: support the test arm by cupping the hand under the elbow. Test: patient pronates forearm. Instructions to patient: “Turn your palm facing outward away from your face.”

Measurement

LOINC Code

0

Scale/Grading

Pass/Fail