| A | B |
|---|
| No evidence of movement | 0 |
| Trace of movement | 1 |
| Full range of motion, but not against gravity* | 2 |
| Full range of motion against gravity but not against resistance | 3 |
| Full range of motion against gravity and some resistance, but weak | 4 |
| Full range of motion against gravity, full resistance | 5 |
| Limb measurement | Asymmetry in limb size |
| Neer test | Shoulder rotator cuff impingement or tear |
| Hawkins test | Shoulder rotator cuff impingement or tear |
| Katz hand diagram | Median nerve integrity |
| Thumb abduction test | Median nerve integrity |
| Tinel sign | Median nerve integrity |
| Phalen test | Median nerve integrity |
| Straight leg raising | L4, L5, S1 nerve root irritation |
| Bragard stretch test | L4, L5, S1 nerve root irritation |
| Femoral stretch test | L1, L2, L3, L4 nerve root irritation |
| Ballottement | Effusion or excess fluid in knee |
| Bulge sign | Excess fluid in knee |
| McMurray test | Torn meniscus in knee |
| Anterior and posterior drawer test | Anterior and posterior cruciate ligament integrity |
| Varus/valgus stress test | Mediolateral collateral ligament instability in knee |
| Lachman test | Anterior cruciate ligament integrity |
| Apley test | Torn meniscus in knee |
| Thomas test | Flexion contracture of hip |
| Trendelenburg sign | Weak hip abductor muscles |
| 1 month | Turns head to side; keeps knees tucked under abdomen; gross head lag and rounded back when pulled to sitting position |
| 2 months | Holds head in same plane as rest of body; can raise head and hold position |
| 3 months | When supine, puts hands together; holds hands in front of face |
| 4 months | Grasps rattle; hands held together |
| 5 months | Can reach and pick up object; plays with toes |
| 6 months | Drops object to reach for another offered; holds rattle or spoon |
| 7 months | Transfers object between hands; holds object in each hand |
| 8 months | Begins thumb-finger grasping |
| 9 months | Bangs objects together |
| 10 months | Points with one finger; picks up small objects |
| 12 months | Feeds self with cup and spoon fairly well; offers toy and releases it |
| 15 months | Puts raisin into bottle; takes off shoes; pulls toys |
| 18 months | Holds crayon, scribbles spontaneously |
| 2 years | Turns doorknob; takes off shoes and socks; builds 2-block tower |
| 30 months | Builds 4-block tower; feeds self more neatly; dumps raisin from bottle |
| 3 years | Unbuttons front buttons; copies vertical line within 30 degrees; copies circle; builds 8-block tower |
| 4 years | Copies cross; buttons large buttons |
| 5 years | Dresses self with minimal assistance; colors within lines; draws 3-part human |
| 6 years | Copies square; draws 6-part human |
| 7 years | Prints well, begins to write script |
| 8 years | Mature handwriting skill |
| 9 years | Eye-hand coordination developed |
| 3 months | Raises head to 45 degrees; may turn from prone to side position; slight head lag when pulled to sitting position |
| 4 months | Actively lifts head, looks around; rolls from prone to supine position; no head lag when pulled to sitting position; attempts to bear weight when held standing up |
| 5 months | Able to push up from prone position with forearms and maintain position; rolls over prone to supine to prone; back straight when sitting |
| 6 months | Sits, posture shaky, uses tripod position; raises abdomen off table when prone; when standing, supports almost full weight |
| 7 months | Uses hands for support; bounces in standing position; pulls feet to mouth |
| 8 months | Sits without support |
| 9 months | Begins creeping, abdomen off floor; stands holding on when placed in position |
| 10 months | Pulls self to standing position, unable to let self down; walks holding on to stable objects |
| 11 months | Walks around room holding on to objects; stands securely, holding on with one hand |
| 12 months | Sits from standing posture; twists and turns, maintaining posture; stands without support momentarily |
| 15 months | Walks alone well; seats self in chair |
| 18 months | Walks up and down steps holding one hand, some running ability |
| 2 years | Walks up stairs alone, two feet on each step; walks backward; kicks ball |
| 30 months | Jumps from object; throws ball overhand; walking more stable |
| 3 years | Walks up stairs alternating feet; walks down steps two feet on each step; pedals tricycle; jumps in one place; performs broad jump |
| 4 years | Walks down stairs alternating feet; balances on one foot for 5 seconds |
| 5 years | Hops on one foot; catches bounced ball 2 of 3 times; heel-toe walking |
| 6 years | Jumps, tumbles, skips, hops; walks straight line; skips rope with practice; rides bicycle; heel-toe walking backward |
| 7 years | Skips and plays hopscotch; running and climbing more coordinated |
| 8 years | Movements more graceful |
| Rising from lying to sitting position | Rolling to one side and pushing with arms to raise to elbows; grabbing a siderail or table to pull to sitting |
| Rising from chair to standing | Pushing with arms to supplement weak leg muscles; upper torso thrusts forward before body rises |
| Walking | Lifting leg farther off floor with each step; shortened swing phase; foot may fall or slide forward; arms held out for balance or move in rowing motion |
| Climbing steps | Holding handrail for balance; pulling body up and forward with arms; uses stronger leg |
| Descending steps | Lowering weakened leg first; often descends sideways holding rail with both hands; may watch feet |
| Picking up item from floor | Leaning on furniture for support; bending over at waist to avoid bending knees; uses one hand on thigh to assist with lowering and raising torso |
| Tying shoes | Using footstool to decrease spinal flexion |
| Putting on and pulling up trousers or stockings | Difficulty may indicate decreased shoulder and upper arm strength; these activities often performed in sitting position until clothing is pulled up |
| Putting on sweater | Putting sleeve on weaker arm or shoulder first; uses internal or external shoulder rotation to get remaining arm in sleeve |
| Zipping dress in back | Difficulty with this indicates weakened shoulder rotation |
| Combing hair | Difficulty indicates problems with grasp, wrist flexion, pronation and supination of fore-arm, and elbow rotation |
| Pushing chair away from table while seated | Standing and easing chair back with torso; difficulty indicates problems with upper arm, shoulder, lower arm strength, and wrist motion |
| Buttoning button or writing name | Difficulty indicates problem with manual dexterity and finger-thumb opposition |
