UE Special Test and Impairment Classificatio

Question 1

What is the Associated ICF Category for Sulcus Sign?

What is the purpose for using the Sulcus Sign?

Answer 1

Movement Coordination Impairment

To determine/assess if there excess laxity, and checking for multidirectional vs unidirectional instabillty

Question 2

What is a (+) for Sulcus Sign?

Answer 2

If there is a presence of a sulcus sign, (a depression greater than a fingerbreath between the lateral acromion and the head of the humerus) when longitudinal traction is applied to the dependent arm in more than one position

Question 3

What is the Associated ICF Category for Apprehension Test? (Apprehension and Relocation Test)?

What is the Purpose of this test?

Answer 3

Movement Coordination Impairment

This assesses instability/anterior dislocation

Question 4

What is considered (+) for the Apprehension Test?

Answer 4

When placed in supine with the arm at 90° of ABD and full ER, and the PT provides overpressure. The patients apprehension, not pain, is considered positive for anterior instability/dislocation.

• Pain with no apprehension may indicate a pathology other than instability (Posterior impingment of the RC)

Question 5

What is the Associated ICF Category for Yergason’s Test?

What is the purpose of this test?

Answer 5

Movement Coordination

&

Muscle Power Deficit

This assesses for Bicep Tendinopathy

Question 6

What is considered (+) for Yergason’s Test?

Answer 6

The patient has their arm positioned at 90° of flexion and pronated, they are asked to supinate their forearm agaisnt resistance

• A (+) is indicated by pain over the biciptial groove or subluxation of Long Head of Bicep (LHB)

Question 7

What is the Associated ICF Category for Drop Arm (Codman) Test?

What is the purpose for this test?

Answer 7

Muscle Power Deficit

To assess for Supraspinatus tear

Question 8

What is considered (+) for Drop Arm Test?

Answer 8

Patient is passively taken to 90° of ABD and is asked to slowly lower their arm with their palm down

(+) If the patients drops at any point of the descent its indicated of a RC tear

Question 9

What is the Associated ICF Category for Lift-off Sign/Internal Lag sign?

What is the purpose for this test?

Answer 9

Muscle Power Deficit

To assess Subscapularis tear

Question 10

What is considered (+) for Lift-Off Sign/Internal Lag Sign?

Answer 10

Pt places their hand behind their back, the PT lifts the pts arm off the back and ask them to maintain the position

• (+) when the patient is unable to maintain his or her arm off the back

Question 11

What is the Associated ICF Category for Active Compression Test/ O’Brien’s Test?

What is the purpose of this test?

Answer 11

Movement Coordination Impairment

To determine the presence of potential pathology of the labrum or AC joint

Question 12

What is considered (+) for Active Compression/O’Brien’s Test?

Answer 12

2 part test: pt stands with their involved shoulder in 90° of flexion, 10° of HAD and Max. IR with the elbow extended, PT adds resistance downward in the distal arm and ask the pt if there is any P! “on top of the shoulder” (AC joint) or “inside the shoulder” (SLAP). The test is then repeated, but with the arm in Max. ER (instead of IR)

• A (+) test for glenoid labral tear if the pt reports pain of clicking pain “inside the shoulder” with resistive force in IR and relief with ER

Question 13

What is the Associated ICF Category for Painful Arc?

What is the purpose of this test?

Answer 13

Muscle Power Deficit

To detect subacromial impingement

Question 14

What is considered (+) for Painful Arc?

Answer 14

Pt stands and ABD their shoulder

• (+) if pt reports pain in the 60-120° range

Question 15

What is the Associated ICF Category for Neer Impingement Test?

What is the purpose of this test?

Answer 15

Muscle Power Deficit

&

Mobility Deficit

Test for shoulder impingement

Question 16

What is considered (+) for Neer Impingement Test?

Answer 16

Passively take patient’s shoulder into full flexion while maintaining internal rotation looking for pain.
If there are no reproduction of symptoms do this motion again and add overpressure by placing one hand on the scapula and the other in the axilla near the glenohumeral joint applying overpressure into flexion and adduction

• (+) if there is a reproduction of Sx

Question 17

What is the Associated ICF Category for Hawkins kennedy Test?

What is the purpose of this test?

Answer 17

Muscle Power Deficit

Assess for Subacromial Pain Syndrome

Question 18

What is considered (+) for Hawkins-Kennedy Test?

Answer 18

The pts arm is taken into flexion, HAD and the shoulder is internally rotated

• (+) if there is a reproduction of Sx

Question 19

What is the Associated ICF Category for Internal Rotation Resistance Strength Test (IRRST)?

What is the purpose of this test?

Answer 19

Muscle Power Deficit

&

Movement Coordination Impairment

To aid in differentiation between outlet (subacromial) impingement vs non-outlet (intra-articular) causes of shoulder pain

Question 20

What is considered (+) for Internal Rotation Resistance Strength Test (IRRST)?

Answer 20

ABD the pt arm 90° and externally rotate 80°, resist the wrist into ER, assess reproduction of SX, then resist IR

• Positive Test: Weaker and more pain with resistive IR compared to ER; Indicated NON-OUTLET (Intra-articular) impingement
• Negative Test: Stronger and less pain with resistive IR compared to ER; Indicated OUTLET (Subacromial) impingement

Question 21

What is the Associated ICF Category for Empty Can (Jobe) Test?

What is the purpose of this test?

Answer 21

Muscle Power Deficit

To determine the presence of a potential Supraspinatus impingement or tear and to assess SIS

Question 22

What is considered (+) for Empty Can (Jobe) Test?

Answer 22

Both arms are in 90° in scaption with the thumbs facing up, apply resistance to both arms, re-test this time with the thumbs down

• (+) would be a decrease in strength or increase in pain with the thumbs down verses thumbs up

Question 23

What is the Associated ICF Category for Load and Shift Test?

What is the purpose of this test?

Answer 23

Movement Coordination Impairment

To assess excessive anterior or posterior mobility at the Glenohumeral joint

Question 24

What is considered (+) for the Load and Shift Test?

Answer 24

With one hand stabilize the scap., the other palpates the humeral head. A compressive force is added through the humeral head in an anterior and posterior direction assessing for movement

• Normal motion anteriorly is half of the distance of the humeral head, more movement is considered to be a sign of GH joint laxity.

Question 25

What is the Associated ICF Category for Clunk Test/Crank Test?

What is the purpose for these test?

Answer 25

Movement Coordination Impairment

To assess labral pathology

Question 26

What is considered a (+) for the Crank Test?

Answer 26

Passively place the pts. shoulder to 160° of elevation in the scapular plane and place their elbow in 90° of flexion. Load the labrum with an axial compression and “crank” the arm into IR and ER

• (+) when there is reporduction of a painful clicking or a deep shoulder pain

Question 27

What is considered a (+) for the Clunk Test?

Answer 27

Place a supinated fist on the pts posterior aspect of the GH joint. PT then passively flexes the pt shoulder to end-range while pronating fist to accenuate instability

• (+) when the shoulder clucks, grinds, dislocates inferring possible labral pathology

Question 28

Which test should you use, the Clunk Test or the Crank Test?

Answer 28

The Crank test, because there is not enough of evidence supporting the clunk test.