MUSCLE TESTING
LOWER EXTREMITIES
MUSCLE TESTING
Muscles of Hip Extension
Muscles of Hip Abduction
HIP EXTENSION
Gluteus maximus
Hamstring
Nerve supply
Inferior gluteal nerve to glutealteus maximus
Sciatic nerve to hamstring
Range of motion
0 to 20 degree
Position of Patient: Prone with knee flexed to 90°
/extended(to check all muscles)
Position of Therapist : Standing at the side to be tested
at the level of the pelvis. Hand for resistance is
contoured over the posterior thigh just above the knee.
The opposite hand may stabilize or maintain the
alignment of the pelvis
Test: Patient extends hip through available range,
maintaining knee flexion. Resistance is given In a new
straight downward direction
Instruction s to Patient: "Lift your foot to the ceiling. "
OR "Lift your leg, keeping your knee bent."
Gradin g
Grade 5 (Normal): Completes available range of
motion and holds end position against maximal
resistance.
Grade 4 (Good): Limb position can be held against
heavy to moderate resistance.
Grade 3 (Fair): Completes available range of motion
and holds end position but takes no resistance
GRADE 2 (POOR)
Position of Patient: Side-lying with test limb
uppermost. Knee is flexed and supported by examiner.
Lowermost hip and knee should be flexed for stability
Position of Therapist: Standing behind the patient at
thigh level. Therapist cradles uppermost leg with
forearm and hand under the flexed knee. Other hand is
on pelvis to maintain postural alignment.
Test: Patient extends hip with supported knee flexed.
Instructions to Patient: "Move your leg back toward
me. "
Grade 2 (Poor): Completes available range of motion in side-lying
position.
Grade 1 (Trace) and Grade 0 (Zero)
This test is identical to the Grade 1 and 0 tests for aggregate hip
extension .The patient is prone and attempts to extend the hip or
squeeze the buttocks together while the therapist palpates the
gluteus maximus. At mid point of buttoks and hamstrings at ischial
tuberosity
MUSCLE TESTING
Hip abduction
RANGE
0 TO 45 DEGREE
GRADE 5 (NORMAL), GRADE 4 (GOOD),
AND GRADE 3 (FAIR)
Position of Patient: Side-lying with test leg uppermost. Start test
with the limb slightly extended beyond the midline and the pelvis
rotated slightly forward.
Lower most leg is flexed for stability.
Position of Therapist : Standing behind patient. Hand used to give
resistance is contoured across the lateral surface of the knee. The
hand used to palpate the gluteus medius is just proximal to the
greater trochanter of the femur (No resistance is used in a Grade 3
test.)
Test : Patient abducts hip through the complete available
range of motion without flexing the hip or rotating it in
either direction. Resistance is given in a straight
downward direction.
Instruction s to Patient: "Lift your leg up in the air.
Hold it. Don't let me push it down. "
GRADING
Grade 5 (Normal): completes available range and holds
end position against maximal resistance.
Grade 4 (Good): completes available range and holds
against heavy to moderate resistance.
Grade 3 (Fair): completes range of motion and holds
end position without resistance
GRADE 2 (POOR)
Position of Patient: Supine.
Position of Therapist : Standing on side of limb being tested. One
hand supports and lifts the limb by holding it under the ankle to
raise limb just enough to decrease friction. This hand offers no
resistance, nor should it be used to offer assistance to the movement.
The other hand palpates the gluteus medius just proximal to the
greater trochanter of the femur.
Test: Patient abducts hip through available range.
Instructions to Patient: "Bring your leg out to the side.
Keep your kneecap pointing to the ceiling."
Grading
Grade 2 (Poor): Completes range of motion supine with
no resistance and minimal to zero friction.
GRADE 1 (TRACE) AND GRADE 0 (ZERO)
Position o f Patient : Supine.
Position of Therapist : Standing at side of limb being
tested at level of thigh. Palpate the gluteus medius on the
lateral aspect of the hip just above the greater trochanter.
Test : Patient attempts to abduct hip.
Instructions to Patient: "Try to bring your leg out to the
side."
GRADING
Grade 1 (Trace): Palpable contraction of gluteus medius
but no movement of the part.
Grade 0 (Zero): No palpable contraction.
Hip extension is performed by Gluteus maximus and
Hamstrings muscle.
These muscle are tested in prone lying in Grade 5,4 3,
and in side lying in grade 2
Hip Abduction is performed by Gluteus medius and
minimus
These muscle are tested in side lying position in Grade
5,4,3 and in Supine lying in Grade 2,1 and 0
