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NONEQUILIBRIUM TESTS

1. Finger-to-Nose – The shoulder is abducted to 90 degrees with elbow extended.


The patient is asked to bring the tip of the index finger to the tip of his or her
nose.
2. Finger-to-Therapist’s finger – The patient and therapist sit opposite each other.
The therapist’s index finger is held in front of the patient. The patient is asked to
touch the tip of his or her index finger to the therapist’s index finger.
3. Finger-to-Finger – both shoulders are abducted to 90 degrees with the elbows
extended. The patient is asked to bring both hands toward the midline and
approximate the index fingers from opposing hands.
4. Alternate nose-to-finger – the patient alternately touches the tip of his or her
nose and the tip of the therapist’s finger with the index finger.
5. Finger Opposition – the patient touches the tip of the thumb to the tip of each
finger in sequence.
6. Mass Grasp – an alteration is made between opening and closing fist (from
finger flexion to full extension).
7. Pronation/Supination – with elbows flexed to 90 degrees and held close to the
body, the patient alternately turns the palms up and down. This test is also
performed with shoulders flexed to 90 degrees and elbows extended.
8. Rebound test – the patient is positioned with the elbow flexed. The therapist
applies sufficient manual resistance to produce and isometric contraction of the
biceps. Resistance is suddenly released. Normally, the opposite muscle group
(triceps) will contract and “check” movement of the limb.
9. Tapping (hand) – with the elbow flexed and the forearm pronated, the patient is
asked to “tap” the hand of the knee.
10. Tapping (foot) – the patient is asked to “tap” the ball of one foot on the floor
without raising the knee; heel maintains contact with floor.
11. Pointing and past pointing – the patient and the therapist sit opposite to each
other. Both patient and therapist bring shoulders to a horizontal position of 90
degrees flexion with elbow extended. Index fingers are touching or the patient’s
finger may rest lightly on the therapist’s. the patient is asked to fully flex the
shoulder and then return to the horizontal position such that index fingers will
again approximate. A normal response consists of an accurate return to the
starting position. In an abnormal response, there is typically a “past pointing”, or
movement beyond the target. \
12. Alternate heel-to-knee; heel-to-toe – from a supine position, the patient is
asked to touch the knee and big toe alternately with the heel of the opposite
extremity.
13. Toe to examiner’s finger – from a supine position, the patient is instructed to
touch the great toe to the examiner’s finger.
14. Heel on shin – from a supine position, the heel of one foot is slid up and down
the shin of the opposite lower extremity.
15. Drawing a circle – the patient draws an imaginary circle in the air with either
upper or lower extremity. This also may be done using a figure-eight pattern.
16. Fixation or position holding – UE: the patient holds arms horizontally in front
(sitting or standing)…LE: the patient is asked to hold the knee in an extended
position (sitting).