Execution:
- Patient is in supine lying position with the knee extended
- The examiner then brushes from distal to the joint line to proximal (towards the patient’s hip) on the medial side of the patient’s knee 2-3 times
- The examiner then brushes down the lateral side of the knee from proximal to distal with the opposite hand 2-3 times
Positive Outcome: A wave of fluid floating down the medial and distal side of the knee where it bulges mediodistally indicates a joint effusion
Sturgill et al. (2009) developed a grading scale for the degree of joint effusion during the Stroke Test:
| Grade | Test Result |
| Zero | No wave produced on downstroke |
| Trace | Small wave on medial side with downstroke |
| 1+ | Larger buldge on medial side with downstroke |
| 2+ | Effusion spontaneously returns to medial side after upstroke (no downstroke necessary) |
| 3+ | So much fluid that it is not possible to move the effusion out of the medial aspect of the knee |
| Study |
Reliability |
Sn | Sp | LR+ |
LR- |
| Sturgill et al. (2009) |
Inter ĸ=0.75 |
NA | NA | NA |
NA |
| Comment: Agreement was scored when two raters scored the same grade of one grade apart. | |||||
