Pendulum Test (Wartenberg)

Download Clinical Summary PDF

Tool Description

  • Introduced in the 1950s as a diagnostic tool of spasticity.
  • Originally a qualitative measure (clinician simply observed the leg swing), the use of electronic equipment to generate quantitative data was introduced in the 1980’s.

ICF Domain:

Body Function – Subcategory: Neuromusculoskeletal & Movement-related Functions and Structures

Number of Items:

1 test, recommended to be repeated up to 4 times at 1 minute intervals.

Brief Instructions for Administration & Scoring


  • The patient sits on an examination table and the examiner holds the patient's foot with the knee fully extended (as straight as possible). The examiner drops the leg, and a computer records the motion and vibration.


  • Typical equipment used is either electro-goniometers, uni-planar video or 3D motion analysis systems.


  • Using computer data for number of oscillations and amplitude, values of the Relaxation index (R1 and R2) are calculated and compared to norms.


MCIDnot applicable in SCI
SEM: not applicable in SCI
MDC: not applicable in SCI

  • Lower scores indicate more severe spasticity.
  • No norms have been established for the SCI population.



Training Required:

Knowledge of spasticity is recommended.


See the ‘How to use’ page of this tool.

Clinical Considerations

  • The Wartenberg Pendulum Test is described as a measure of spastic hypertonia. It was proposed as a method of measuring the effects of therapeutic intervention on spasticity
  • Its usefulness and validity in any population suffering from spasms is debatable
  • Computer equipment is required.  Although the test itself is quite simple, collecting quantitative information is more consuming.
  • This test has not been validated in a SCI specific population and its validity in other populations is debated.

Measurement Property Summary

# of studies reporting psychometric properties: 1


  • There were no significant differences between seven trials of the pendulum test performed at the end of manual muscle testing (P=.64).
  • Inter-trial reliability is High (ICC=0.92).

[Smith et al. 2000]


  • Average manually applied velocities during the MMT were compared to muscle tone score from pendulum testing. Higher levels of muscle tone corresponded to lower applied velocities and vice versa, suggesting an inverse relationship between these two variables.
  • Correlations between pendulum test score and average velocity were significant and High for two of the three therapists and non-significant and Moderate for the third therapist (A: Pearson’s r=0.223, P=.32; B: Pearson’s r=0.657, P<.001; C: Pearson’s r=0.67, P<.001). Including all three data sets gave an average correlation of 0.638 and significance level of 0.001.

[Smith et al. 2000]

No values were reported for the responsiveness of the Pendulum test.

Floor/ceiling effect:

No values were reported for the presence of floor/ceiling effects in the Pendulum test for the SCI population.


Dr. Vanessa Noonan, Matthew Querée, Risa Fox

Date Last Updated:

August 24, 2020

Download the measure

Download Worksheet:

Worksheet Document
This test is performed with the subject half-lying. The patient is instructed to relax his/her knee. The leg is then dropped from a near-full extension and the characteristics of the knee oscillation are evaluated. Specifically, the administrator of the test should observe the number of oscillation following the drop of the leg.




Equipment Needed

Typical equipment used is either electro-goniometers, uni-planar video or 3D motion analysis systems.

Pendulum Test:

Smith AW, Kirtley C, Jamshidi M. Intrarater reliability of manual passive movement velocity in the clinical evaluation of knee extensor muscle tone. Arch Phys Med Rehabil, 2000; 81: 1428-31.