What does the Brunnel-Littler Test assess?

The Brunnel-Littler Test specifically assesses intrinsic muscle tightness, particularly in the context of the hand, where it helps differentiate between tightness of the intrinsic muscles and the presence of joint issues.

When conducting the test, the clinician manipulates the metacarpophalangeal (MCP) joints while observing the ability of the fingers to flex at the proximal interphalangeal (PIP) joint. In cases of intrinsic muscle tightness, if the PIP joint cannot flex adequately even when the MCP joint is held in a flexed position, this indicates that the intrinsic muscles, such as the lumbricals and interossei, are tight or shortened.

Conversely, if the PIP joint can flex adequately when the MCP joint is flexed, this suggests that the limitation in movement may not be due to intrinsic muscle tightness but rather to other factors, such as capsular tightness or retinacular ligament issues. Thus, the Brunnel-Littler Test serves as an important tool in physical therapy for evaluating hand conditions, confirming that the primary function of the test is to detect intrinsic muscle tightness.