Assessing tone is best done with which type of stretch?

• A. Active
• B. Isometric
• C. Passive
• D. Resisted

Answer: (C)

When you assess tone, you want to measure how much resistance the muscle offers to being lengthened without the patient actively contracting. A passive stretch lets you move the limb through its range without the person using their muscles, so the resistance you feel comes from the muscle’s baseline tone and reflexive properties rather than voluntary effort. This is essential for identifying abnormal tone, such as velocity-dependent resistance seen in spasticity, because active or resisted movements would contaminate the measurement by engaging the patient’s voluntary or externally driven muscle activity. Isometric holds don’t involve lengthening the muscle, so they don’t reveal how the muscle resists stretch. In short, passive stretch isolates the passive and reflexive components of tone, making it the best choice for assessment.