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Elbow Resisted Tests and Testing | Clinical Physio Premium
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hey everyone and welcome back to
clinical physio with me Khalid Maiden in
this video we're going to show you how
to effectively test the resistive
movements of the elbow joint so that we
can assess the active contractile
structures influencing this joint when
going through these tests there's two
key things that we need to think about
pain and power the latter of which can
be assessed between 0 and 5 on the
Oxford scale so time to get into our
main video let's get clinical so now
we're going to look at resisted test of
the elbow and in particular flexion and extension
extension
let's start with flexion so for this
test we're going to start with the
therapist next to the patient like so
with one hand supporting the elbow joint
and the other hand just proximal to the
wrist joint it's important to note that
we should not be gripping the patient's
forearm so have the fingers splayed out
in front of you we're also going to have
our body weight angling down towards the
patient's elbow as this will allow you
to generate more force for your test we
need to make sure that the patient's
help the patient's shoulder is in a
neutral position as if it was in an
abducted position this may give more
interaction from other muscles around
the area such as the pectoral muscles in
terms of a command to give the patient
as they do the movement we can say one
of two things either push against me or
don't let me move you so for our test we
assume in the position and we say to
live don't let me move you don't let me
move you don't let me move you and relax
so when we're doing this test the
muscles involved are the biceps brachii
brachialis brachioradialis and pronator
Terry's and where we do the tests we're
looking at pain and a score on the
Oxford scale from zero to five if we do
elicit pain with the test it tells us
that there is a dysfunction when one of
the muscles we've just mentioned has
actively contracted finally it's
important for this particular test to
perform with elbow
election at 90 degrees as if you perform
it with increased elbow extension it
puts much more tension on the long head
of biceps tendon at the shoulder joint
so that's how we test resisted elbow
flexion we're now going to look at
resisted elbow extension and I'm going
to change my position so that I'm facing
away from the patient my two hands are
underneath the patient's forearm on the
posterior side again with the fingers
out splayed so that we don't grip the
patient's forearm
we're going to ask the patient as we did
before don't let me move you so live
don't let me move you don't let me move
you don't let me move you in this
position we also want to keep the
shoulder in a neutral position so again
as to stop other muscles working because
the muscles we do on a test with elbow
extension are the triceps muscles and
anconeus which has minimal activity
during this test again we look for pain
and a scale of 0 to 5 on the Oxford
score if we do elicit pain with this
test that may tell us that active
contraction of the triceps or anconeus
so now we're going to look at resisted
movement of the elbow in terms of
supination and pronation first we're
going to look at supination so for this
test the patient's arm is in a position
as so so that the wrist is in neutral
with the thumb facing the ceiling the
elbow is going to be tucked in towards
the ribs to prevent any rotation at the
shoulder joint this is the position you
should take in practice for the purpose
of this video so that you can see easily
I'm going to bring the elbow over here
so next we have our handling as we are
trying to resist supination we have one
arm on the posterior aspect of the
forearm with the fingers gently over the
top of the radius bone this is so that
we can use this hand to block the
movement of supination our other hand is
going to be positioned as if we were
hand shaking the patient's forearm this
is just actually there as a supporting
movement for when we do the movement for
the resisted test
so in this position we're going to use
the same commands as we did before
either push against me or don't let me
move you so we're going to say to live
don't let me move you don't let me move
you don't let me move you as we test
supination the muscles involved in super
nation are supinator muscle biceps
brachii and break your radialis and when
we analyze the supination movement we're
going to look for pain to see if any of
those muscles are involved in the
patient condition we're also going to
analyze their score on the Oxford scale
between 0 and 5 we're now going to
change position so we can show you
pronation so for the pronation movement
the patient's arm is in the similar
starting place as we had with supination
the only difference is with our hands so
the therapists hand for resisting
pronation is going to be placed on the
anterior surface of the forearm with the
fingers gently looping over the top of
the radius so that we can block the
pronation movement as so as we had with
supination our other hand is the
supporting hand which is positioned as
if we were hand shaking the patient's
forearm from here we can use the same
commands as before and we can say to
live don't met let me move you don't let
me move you don't let me move you as we
block into pronation the muscles
involved in pronation are pronator
terry's pronator quadratus and break
your radialis
and so when we do the pronation test
we're looking to see if activating these
muscles causing pain and we also look to
see the score on the Oxford scale
between 0 and 5 so let's go through some
key points to summarize this video on
elbow resisted tests make sure you
compare both the affected and unaffected
sides as you test resisted elbow flexion
extension supination and pronation make
sure you're aware of the handling and
the therapist and patient position for
each test
when completing a test look for two key
elements pain and power which is
measured between 0 and 5 on the Oxford scale
and that completes our video on resisted
test of the elbow joint next I'd like
suggest you have a look at our other
videos within the clinical physio elbow
assessment catalog including active
range of movement testing and passive
range of movement testing thank you as
always for joining us here on clinical
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