Medical professionals use manual muscle testing to describe the amount of muscle strength of their clients. Most professionals use the Daniels and Worthington muscle grade to rate the result. Laypersons can also conduct manual testing of wrist flexion.
Step 1
Test the strength of the patient's wrist flexion by placing your hand on the back of the patient's hand just below the wrist and your other hand on the back of the forearm just above the wrist.
Step 2
Adjust the position of the patient's hand based upon the amount of strength in the wrist. Use the gravity eliminated position, where the patient's thumb faces upwards, if the wrist is too weak to move fully. Test the wrist against gravity, with the patient's palm facing downward and the thumb towards the body, if the wrist is able to move throughout its range of motion, which is 80 to 90 degrees flexion.
Step 3
Ask the patient to move her wrist. If she can achieve full range of motion, straighten the wrist and apply resistance to the palm of the hand while they actively push against your hand.
Step 4
Use Daniels and Worthington Muscle Testing Grades to determine the amount of strength in the wrist. This ranges from zero, "cannot feel or observe any muscle contraction," through "fair," when the wrist in the against-gravity position has a 50 percent range of motion but cannot achieve full range of motion, to the best result, 5, for a wrist that can move with full resistance applied when positioned against gravity.
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