Wrist/Hand Resisted Isometric Testing

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Resisted Isometric Strength Testing of the Wrist & Hand

After completing active and passive range of motion assessment you’re going to continue with resisted isometric muscle testing. During resisted isometric muscle testing of the wrist & hand you’re also going to include wrist flexion and extension as some of the forearm muscles are attached to the humeral epicondyles.
During resisted isometric muscle testing of the wrist and hand, you’re also going to evaluate the movements of pronation and supination which we covered in our post on the elbow joint.

For resisted isometric testing of the wrist and hand you can have your patient sit on a stool with the forearm resting on the bench.

Wrist Extension: To assess wrist extension, fixate the distal forearm and apply resistance on the dorsum of the hand.
Wrist Flexion: To assess wrist flexion, fixate the distal forearm and apply resistance on the palm of the hand.

For radial and medial deviation, the patient may make a fist.

Radial Deviation: With one hand fixate the distal forearm and then apply resistance against movement of the wrist towards the thumb (radial deviation).
Ulnar Deviation: With one hand fixate the distal forearm and then apply resistance against movement of the wrist towards the pinky (ulnar deviation).

Resisted Isometric Testing of the Hand & Fingers:

Finger Flexion: A really functional way to conduct resisted isometric testing for finger flexion is to ask your patient to give you a firm handshake. If you want to get information on individual joints you can go ahead and give resistance to those
Finger Extension: To assess extension, have your patient’s hand lie flat on the bench. Put your hand on the patient’s fingers, fixate with the other and then ask the patient to lift up your hand while you apply resistance to the fingers.

For resisted isometric testing of finger adduction and finger abduction, you can simply intertwine your fingers with those of the patient.

Finger abduction: Ask your patient to squeeze the fingers while you give resistance.
Finger abduction: Ask your patient to try to spread the fingers while you give resistance.

For resisted isometric testing of the thumb, fixate the hand including the scaphoid bone with one hand and make a fist around the patient’s thumb with your other hand.

Thumb abduction: Resist the movement of the thumb perpendicular to the palm of the hand
Thumb adduction: Resist the movement of the thumb toward the palm of the hand
Thumb extension: Resist the movement of the thumb in the plane of the palm toward the radius
Thumb flexion: Resist the movement of the thumb in the plane of the palm toward the ulna

Also check out our post on active range of motion assessment as well as passive range of motion assessment of the wrist and hand.