Clinical reliability of the pendulum test in the assessment of muscle tone

A. Grippo, A. Pizzi, A. L. Casini, K. Falsini, F. Puglisi, O. Ronchi

Research output: Contribution to journalArticlepeer-review


The traditional method for the clinical assessment of muscle involves estimation of limb resistance to passive stretching. Although the method is simple to apply, results are neither quantitative nor objective. A number of simple tests have been introduced to quantify spasticity, one of which is the 'Pendulum test'. We appraised its utility in 127 patients (87 with spinal cord lesions, 37 with hemiparesis and 13 with Parkinson's disease). The control group consisted of 29 healthy age- and sex-matched subjects. Measurements obtained from each pendulum test were: 1) the relaxation index (RI), calculated as the ratio between the angle difference of the first downswing and the difference between the initial position and the final resting position; 2) the number of oscillations; 3) the maximum velocity (V(max)) of the first swing; 4) the presence of reflex-EMG burst (R-EMG). Multivariate analysis showed that RI and R-EMG were significantly related to muscle tone alterations. In addition, EMG recording proved to be of value in controlling for muscle relaxation and in identifying different patterns of hypertonus. The 'Pendulum test' provided quantitative and reliable estimates of muscle tone, which were closely correlated with clinical status. The test should also be useful for the quantitative assessment of drug treatment and/or physiotherapy on spasticity and rigidity.

Original languageEnglish
Pages (from-to)59-68
Number of pages10
JournalEuropa Medicophysica
Issue number2
Publication statusPublished - 1997


  • Hemiplegia
  • Muscle tone
  • Parkinson's disease
  • Pendulum test
  • Spasticity
  • Spinal cord injury

ASJC Scopus subject areas

  • Rehabilitation


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