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56 Cards in this Set
- Front
- Back
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Scapular Assistance Test (SAT)
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Dx: Scapular dyskinesia
Manually assist post. tilt and upward rotation of the scapula during AROM. Positive: If sx decrease with assistance then "+" and suggestive of dyskinesia. if + then indicative for taping |
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Murphy's Sign (Gall Bladder/Liver)
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Dx: to differentiate the etiology of RUQ abdominal pain
Place fingers below costal margin at the mid-clavicular line. Instruct patient to breathe in. Positive: If patient stops breathing in and winces then test is +. Must perform Bilaterally to confirm true + |
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Scapular Lateral Slide Test
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Dx: Scapular Hypermobility
Step1: arms at side and take measurement Step2: hands on hips with thumbs posterior - measure Step3: arms abducted to 90 degrees with thumb down - measure measure (in cm) from the inferior angle of scapula to the spinous process. Positive: Should not be >1.5 cm from step 1 to step 2 or 3. If so then + for scapular hypermobility. |
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Apley's Test
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Dx: FROM assessment
- have pt place hand behind back. -combined motion of IR and Adduction and combined motion of ER and Abduction (make note of spinal level) |
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PST Measurement
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Patient is sideline with half of humerus off the table. The arm is then abducted to approx 90°. Then retract the scapula and dont allow it to move. Then guide the arm down (into hor. add.) until point of restriction. Then either measure distance from fist to elbow or use inclinometer.
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Pec Minor Tightness
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Patient is supine with arms at side and neck in neutral. Measure distance from the posterior acromion to the table. Then apply an A/P force at the coracoid to determine if pain or resistane is encountered. Pain or strong resistance when pushing down and/or assymetry greater than 6cm is indicative for Pec minor tightness.
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Supraspinatus muscle test
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Elevate arm approx 60° in the scapular plane with the thumb down. (empty-can postn.) Then apply preasure above the elbow.
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Infraspinatus muscle test
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2 positions:
1-elbow at side in 45° IR 2-arm elevated 90° in saggital plane with arm in 45° IR. (Support their elbow) |
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Bear Hug Test
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Dx: Upper Subscapularis Tears
-Place arm on opposite shoulder w/o gripping. -Then try to lift their hand off while they resist. positive: inability to hold hand on shoulder |
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Gerber Lift-Off test
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Dx: Lower Subscapularis Tears
-Place patient arm behind their back -then have them lift their hand off their back. -Then you apply force with a few fingers in direction of pushing their hand into their back. Positive: inability to hold arm off back |
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Single arm shot put for distance test
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Test is for Power.
Position: -Standard chair with no arm rests -Pt is long sitting (feet are supported on another chair) -Non throwing arm is placed on opposite shoulder -A strap is placed diagonally over the non tested shoulder -Throwing arm is positioned in the scapular plane. DONT allow pt to cock arm back Procedure: -Use a 6lb medicine ball -Have pt warm up a few times with some shoulder flx movements. -Then ''put'' the ball as far as they can without leaning forward. -Measure distance from front of chair to first spot where ball lands. |
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Timed push up test
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Test is for Power
Position: -Men use standard postn. -Women are with knees bent -Hands are shoulder width apart Procedure: -Max effort for 15 seconds -Take a 45 sec rest -Mean score of 3 sets is used |
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Timed pull up test
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Position:
-Using two tables and a bar or a smith machine -Women are with their knees and legs supported on a bench -Men are with ONLY their heels supported -Hands are shoulder width apart -Pull up until arms are parallel to the floor. Procedure: -Max effort for 15 second bout -45 sec rest -Mean score of 3 sets used ***Knees should NOT come up as they pull---start with arms completely extended Test is for Power |
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Fit-HaNSA: Test 1
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Equipment:
-3 one kg containers -adjustable shelves -1 shelf placed at eye level -1 shelf placed 25 cm. below -metronome or stopwatch Procedure: -Participant repetitively moves containers between shelves at pace of 1 per second for up to 5 minutes. Norms: Patient: 246 sec Control: 290 sec (5min=300 sec) |
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Fit-HaNSA: Test2
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Equipment:
-2 screws (nut and bolt) -1 shelf placed at eye level -1 peg board -stopwatch Procedure: -pt. repetitively moves screws between 3 holes for up to 5 minutes. Average times: Patient-275 sec Controls-300 sec (full time) |
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Glenohumeral Inferior Glide
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Sitting:
-Place one hand over top of shoulder -Apply inferior glide just above elbow -Use your thumb to assess depth of displacement (sulcus sign) Supine: -Assess in resting postn. first (23-55° scaption)***have towel/weight under scapula to stabilize -apply distraction at distal humerus and assess for sulcus sign with other hand -bring arm into approx 90° abduction with thumb up and apply inferior glide here for my aggressive approach ***know breadth of my thumb |
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Glenohumeral posterior glide
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Assess:
-Assess first via load and shift -stabilize at scapular spine and clavicle -apply load/compression then post/lateral shift Treatment: -start in resting position (23-55° scaption) and then progress to limited range -IR and/or Horizont Adduct to make more aggressive ***Post. Glide norm = 3-20mm |
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Glenohumeral anterior glide
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Assess:
Assess first via load and shift Treat: -lay pt prone with towel just medial to humeral head -bring arm into approx 80° abduction and apply glide in Anterior-slight medial direction ***Ant. Glide norm= 2-13 mm |
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SC joint inferior glide
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Position:
-pt supine -stand above pt's head -apply inferior glide with slight oblique angle at medial portion of clavicle using both tips of thumb Progress: -have pt shrug shoulder and then apply inferior glide |
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SC joint superior glide
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-pt supine
-apply superior glide at medial clavicle Progression: -to advance have pt depress shoulder by placing hand underneath their butt |
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SC joint anterior glide
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-pt supine
-place fingers underneath medial portion of clavicle and pull up Progression: -have pt Hor. Adduct arm |
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SC joint posterior glide
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-pt supine
-using both thumbs push posterior at the medial clavicle Progression: -have pt hor. Abduct arm (use pillow under hand for support) |
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Shear Test
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Dx: AC joint disorders
-pt seated -cross fingers with hands over scapula and clavicle -compress at scapular spine and at clavicle simultaneously Positive: instability or concordant pain ***can also be used for mobilizing |
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CF Supraspinatus
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-Pt seated
-Arm behind back -Maximum extension and adduction -Tendon is just inferior and slight lateral to AC joint. -Runs in oblique angle ***Peroform isometric contraction b/w 0-60° in scaption hold 6-10 secs |
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CF Infraspinatus
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-Grasp patients hand
-90° flx -20° ER -10° hor. adduction -locate post-lateral acromion and tendon is just inferior to it -tendon runs horizontally ***Isometric contraction 6-10 sec of ER's |
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CF Teres Minor
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-Grasp patients hand
-90° flx -20° ER -10° hor. adduction -locate post-lateral acromion and tendon is just inferior to the infraspinatus tendon -tendon runs horizontally ***Isometric contraction 6-10 sec of ER's |
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CF Long Head of Biceps
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-pt seated
-arm in 20° IR (on lap) -palpate for coracoid -then move just lateral to coracoid -to confirm you're in groove passively rotate arm into IR/ER -with arm in 20° IR apply CF -Tendon runs mainly vertical ***you can also have pt raise arm in scapular plane and in b/w ant. and med. deltoid there's a groove. This same groove is where the long head biceps tendon lies with the arm down and in 45° IR. ***Isometric contraction of biceps 6-10 secs |
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CF Subscapularis
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-pt seated
-arm in neutral -palpate for coracoid -then move just lateral to coracoid -tendon runs mainly vertically ***Isometric contraction of IR's |
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Spurlings Compression
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-to differentiate etiology of radiculopathy or referred pain
-ipsilaterally flex neck 30-45°. -Axial compression -Positive if symptoms worsened or reproduced by test are likely of cervical origin |
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Bakody
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-to differentiate b/w etiology of shoulder vs neck pain
-ask pt to place hand on top of head -positive if sx worsened of a shoulder origin. If sx reduce then is indicative of cervical origin ***by placing hand on neck you're: -putting nerve on slack -Decreasing intraneural pressure -decreases tension on hoffman ligaments of dura **this is why cervical radiculapathies stop hurting when placing hand on head |
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Hawkins-Kennedy
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Dx: impingement syndrome (subacromial & subcoracoid)
-pt seated -flex pt's arm to 90° while maintaining 90° elbow flx -slight hor. adduction -slowly internally rotate arm -have your other arm over their shoulder and don't allow to elevate -Positive if concordant pain |
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Neer Test
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Dx: impingement syndrome (subacromial)
-pt seated -flx pt's arm overhead (palm down) with one hand -other hand stabilizes at their scapula -note pt's response through arc of movement Positive: concordant pain ***Can perform in 3 planes: 1-Shoulder flx (palm down) 2-Scaption (thumb up) 3-Abduction (thumb up) |
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Impingement Relief
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Dx: impingement syndrome (subacromial)
**done if pt had a ''+'' Neer test -pt seated -place their arm over your shoulder -apply inferior glide at the level that was painful during Neer test Positive: the pain is decreased with inferior glide - |
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Cross Arm
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Dx: Impingement Syndrome (subcoracoid) & also AC joint disorders
-pt seated or standing -horizontally adduct pt's arm from a 90° position -with a slight IR -go until you get an endfeel -prevent pt from rotating torso Positive: concordant pain |
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Drop Arm Test
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Dx: RC tear (supraspinatus)
-pt standing -passively elevate pt arm to 90° abduction (palm down) -release arm and ask pt to slowly lower it Positive: pt unable to hold arm up and lower in smooth manner. Pt will shrug shoulder and then lower it. ***have your arm under theirs just incase their arm drops |
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Lag Sign
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Dx: RC tear (infraspinatus)
-pt seated -support their arm at elbow -move arm to 20° of scaption -ER the pt's arm Positive test: pt unable to hold ER ***make sure ER is not so much that gravity wont let their arm drop |
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Drop Sign
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Dx: RC tear (Infraspinatus & Teres minor)
-pt seated -support them at elbow -raise their arm to 90° of scaption -ER their shoulder Positive: pt unable to hold ER |
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Belly Press
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Dx: subscapularis tears
-pt seated -pt places hand on abs -pt presses hands into abs and IR (elbow should move forward) Positive: elbow does NOT move forward. This implies inability to IR |
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Speed's Test
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Dx: long head biceps disorder
-pt seated or standing -flx pt arm 60° with supination (palm up) -Place one of your hands over their long head biceps tendon -resist their flexion (below elbow) Positive: pain around bicipital groove ****resist at 30° too (may resist anywhere from 0-60°) |
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Yergason's Test
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Dx: tests transverse humeral ligament ability to stabilize long head biceps tendon within groove
-pt flexes elbow 90° -adduct arm so elbow is at side -forearm pronated -place your hand over area of bicipital groove -ask pt to supinate while you resist Positive: pain at bicipital groove ***increase sensitivity by asking pt to flex at elbow, ER shoulder and supinate at the same time while you resist all 3 motions |
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Crank Test
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Dx: Labral Disorders (SLAP)
-pt supine -shoulder 160° of scaption -elbow flexed 90° -apply compression into the fossa via the elbow -while maintaining compression apply CW and CCW (IR/ER) (Slowly increase the size of the rotations) positive: concordant pain, catching, clicking ***160° of scaption is called "Zero Position" b/c it places the least amount of stress on the capsule |
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O'Brien Test/Active Compression Test
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Dx: Labral disorder (anterior/posterior SLAP) & also for AC joint disorders
Step 1: -pt is standing -shoulder flexion of 90° with 10° adduction and thumb down -apply resistance (above elbow) Step 2: -Same position as above but now with thumb UP -Apply resistance above elbow Positive: Pain (felt inside the shoulder for labral disorder) or clicking with Step 1 that is better with Step 2 -For diagnosing AC Jt. disorders the pain should be felt in that area to be positive |
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Bicep Load Test
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Dx: Labral disorder (SLAP)
-pt supine -shoulder in 90° abduction and ER -Elbow in 90° flexion and forearm in supination (Bicep Pose) -pt is asked to flex elbow while you resist Positive: pain with elbow flx |
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Anterior Slide Test
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Dx: labral disorders (SLAP)
-pt sitting or standing with hands on hips with thumb pointing back -stabilize scapula/clavicle -apply ant-superior force through elbow while pt tries to resist Positive: pain, clicking/popping |
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Kim Test
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Dx: Posterior Inferior Labral Lesion
-pt is seated with back supported -abduct pt's arm to 90° -apply axial load to the humerus in a post-inferior direction while slightly elevating arm with slight IR |
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AC Resisted Extension Test
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Dx: AC joint disorders
-pt is seated or standing Step1: -pt abducts arm to 90° with 90° elbow flex -pt attempts to horizontally abduct while you resist Step 2: -pt arm is then flexed to 90° with elbow in 90° flx -pt then attempts to horizontally abduct from this position while you resist Positive: concordant pain (specifically at the ACJ) |
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Load and Shift Test
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Dx: Anterior or Posterior Instability
-pt sitting upright -grab proximal portion of humerus at the BONE -humerus centered in fossa via compression at humeral head -apply ant-medial glide and then post-lateral glide to assess for increased laxity -do a few reps so shoulder can relax ***can also be done with shoulder supported in 90° of abduction |
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Apprehension Test
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Dx: anterior instability (occult instability)
-pt supine -pt one hand over shoulder jt but DON'T apply any force. It's only there for pt safety -passively place arm into 90° abduction & then ER arm until an end-feel (90-90° pstn) -Use your knee to help support their elbow Positive: apprehension, guarding, pain ***Follow up this test with Relocation test (post-force to GH joint) for increased dx accuracy |
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Relocation Test
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Dx: Anterior instability
-pt supine -pt one hand over shoulder jt -passively place pt arm into abduction (90°-90° position) & then ER arm until an end-feel -Use your knee to help support their elbow -Once apprehension and pain is noticed then apply posterior force to proximal humerus Positive: decreased pain or apprehension once posterior force is applied ****done in combination with "Apprehension Test" **upon finding + reduce ER before releasing Posterior force to avoid subluxing |
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Posterior Drawer Test
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Dx: Posterior Instability
-pt supine -stand b/w pt's arm and body -Abduct pt arm to 90° -slightly horizontally adduct arm -have one hand support at elbow -other hand applies post-lateral force at proximal humerus -apply counterforce at elbow Positive: pain, apprehension ***you can apply slight IR to icrease sensitivity **apply force slowly |
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Sulcus Sign
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Dx: GH instability
-pt seated -stabilize at scapula spine and clavicle -pull down (inferior) and out at distal humerus -access with the side of your thumb first and if it goes all the way then turn thumb to the thicker side and assess that way ***Normal inferior glide translation is 5-15mm **know the size of your thumb so you can assess if its "+" |
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Scalene Muscle Length Assessment
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Dx: tight scalenes
Step 1: have pt laterally flex head to right and left with arms at side Step 2: passively abduct pt's arm to >90° and support them at that position -now have them laterally flex once more Positive: if cervical mobility increases with arms elevated then test is "+" |
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First Rib Assessment
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Dx: elevated first rib
Step 1: check for symmetry: -pt seated -be at eye level and then palpate both sides of upper traps simultaneously by pushing down with index/middle fingers Step 2: Spring test for mobility/1st Rib Mobilization -Stand behind seated pt with leg on chair/mat to stabilize pt's trunk -have pt place their arm over your leg to stabilize their trunk -Laterally flex pt's head towards the affected side, and then extend and rotate away from it -once positioned apply a force to the 1st rib using a inferior-medial direction (oblique) -Push down with your hand in a "karate chop" position *****Muscle energy technique: -Ask pt to inhale while resisting elevation of the 1st rib and then apply mob during exhalation ***use maitland/kaltenborn when applying mobs and when performing "spring test for mobility" apply a couple reps just for assessing |
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Costoclavicular Test
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Dx: TOS compression at the costoclavicular region
-have pt seated while you stand from behind -palpate for their radial pulse first -then have pt sit upright with exaggerated military posture -position held for 1 min (or as tolerated) Positive: -Diminshed pulse -concordant sx reproduction ***extension of the arm with downward distraction may increase sensitivity |
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Hyperabduction Test
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Dx: TOS compression underneath pec minor
-pt seated -palpate radial pulse first -then have pt sit upright and place arms in 90-90 position (support their arm) -hold position for 1 min Positive: -diminished pulse, concordant sx reproduction (vascular or neurological) ****to increase sensitivity have pt rotate head to opposite side. This is now called the WRIGHT'S TEST |
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Adson's Test
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Dx: TOS compression at the scalene junction
-pt seated -palpate radial pulse with pt sitting with their arm abducted 15° -pt then instructed to inhale, hold breath -then extend head, and rotate head toward the tested side Positive: -concordant symptom reproduction or diminished pulse (vascular or neuro) ***to make more sensitive have pt rotate head away from tested side |
