UE Special Tests - Skills Checkoff Flashcards
explain ER lag sign
- positioning
- protocol
- what a positive indicates
patient seated with
elbow passively flexed to 90
slight abduction
maximal ER at shoulder
patient asked to maintain this position
positive = patient arm fall into IR
– indication for MPD of rotator cuff
– when paired with cluster, major RTC lesion is indicated
explain IR lag sign test
- positioning
- protocol
- what a positive indicates
patient seated with arm behind back in extension and max IR
therapist lifts arm off the back and asks patient to maintain this position
(+) = if arm falls out of position
– muscle power deficit of RTC muscles
– if paired in cluster, major lesion of RTC musculature is indicated
explain Painful Arc Test
- positioning
- protocol
- what a positive indicates
patient is asked to actively elevate the arm into abduction
(+) = if pain is present during motion / lack of ability to complete motion
– MPD for subacromial pain syndrome
what is the cluster for subacromial pain syndrome
Hawkin’s Kennedy
Painful Arc
Painful/Weak ER resistance test
Neer’s
explain Hawkin’s Kennedy Test
- positioning
- protocol
- what a positive indicates
patient seated
arm passively taken into 90 degrees of flexion, horizontal adduction
therapist stabilizes top of shoulder and instructs patient to IR arm in position
(+) = limited range / pain in shoulder
– used in cluster for MPD of subacromial pain syndrome
explain Neer’s
- positioning
- protocol
- what a positive indicates
patient seated
shoulder passively taken into flexion with max IR
- if no pain or repro of symptoms, add overpressure at max flexion into FLEX/ADD
(+) = pain/reproduction of symptoms or inability to complete motion fully
– MPD for subacromial pain syndrome
explain Belly Press Test
- positioning
- protocol
- what a positive indicates
patient seated with palm of affected limb on belly
pt instructed to push their palm into their stomach (will contract internal rotators)
(+) = patient flexes at the wrist or tries to extend the shoulder to press into stomach
– MPD of IR musculature
explain acromioclavicular shear test
- positioning
- protocol
- what a positive indicates
patient seated with arm resting by side
therapist makes a cup with hand, placing one hand on anterior and one hand on posterior part of AC joint
- squeeze together over AC Jt
(+) = reproduction of symptoms noted at AC jt
– test for movement coordination deficit
explain anterior apprehension with relocation test
- positioning
- protocol
- what a positive indicates
patient in a supine position
- elbow flexed to 90
- shoulder abducted to 90
- stabilize humerus on leg of therapist
move patient into ER
—– if pain or apprehension is felt before end range, add posterior force to shoulder to reposition
move further into ER
slowly release posterior force
(+) = pain and apprehension in original ER position / pain and apprehension in secondary ER position
—- test for movement coordination deficit at shoulder
explain Sulcus Sign Test
- positioning
- protocol
- what a positive indicates
patient seated with arm relaxed and by side
therapist stabilizes proximally at shoulder
other hand grabs distal humerus and applies an inferior traction force
(+) = visible step down deformity
– movement coordination deficit
– could indicate superior labrum tear
explain anterior slide test
- positioning
- protocol
- what a positive indicates
patient with hand on hip
therapist palpates distal humerus
applies superior / anterior force (towards patient’s ear - in line with humerus)
(+) = clicking/pain in shoulder
– movement coordination deficit
explain biceps load test
- positioning
- protocol
- what a positive indicates
patient in supine position
shoulder abducted to 120 degrees with full ER
elbow flexed to 90 degrees
forearm supinated
patient asked to flex elbow while therapist resists at distal forearm (trying to take elbow into extension)
(+) = deep pain, lack of ability to maintain position
– movement coordination test
– SLAP lesion
explain moving valgus stress test
- positioning
- protocol
- what a positive indicates
patient seated with shoulder in 90 abduction
forearm in neutral
therapist adds valgus stress (if standing behind, push anteriorly)
moves arm through 70-120 degrees of elbow flexion
(+) = reproduction of symptoms
– movement coordination test of UCL ligament
explain Cozen’s test
- positioning
- protocol
- what a positive indicates
patient seated with
- elbow in full extension
- wrist extended, pronated and slightly radially deviated with hand in full fist
therapist applies force into flexion and tells patient to resist
(+) = reproduction of symptoms
– testing for MPD at lateral epicondyle
– testing for lateral epicondylalgia
explain Maudsley’s test
- positioning
- protocol
- what a positive indicates
patient seated with
- elbow flexed to 90 degrees
- middle finger extension
resistance applied into flexion and patient instructed to resist
(+) = reproduction of symptoms at lateral epicondyle
– test for MPD
– lateral epicondylalgia
what is the cluster of tests for lateral epicondylalgia
Cozen’s
Mill’s
Maudsley’s
explain Mill’s Test
- positioning
- protocol
- what a positive indicates
patient seated with:
- shoulder in 70 degrees of abduction
- elbow at 90 degrees of flexion
- involved thumb inside of fist
- wrist flexed and ulnar deviation
therapist maintains wrist position and passively extends the elbow
(+) = pain reproduction at lateral epicondyle
– MPD test for lateral epicondylalgia
explain Ballotement’s Test
- positioning
- protocol
- what a positive indicates
patient seated with palm facing up
therapist pinches triquetrum with one hand
grasps lunate and moves it in palmar and dorsal direction
(+) = laxity, popping or pain reproduction
– movement coordination deficit test
– carpal instability
explain Finklestein’s test
- positioning
- protocol
- what a positive indicates
patient seated with thumb tucked into fist
patient asked to deviate in ulnar direction slowly
(+) = reproduction of pain over APL / EPB tendon at wrist
– MPD test for De Quervain’s tenosynovitis
explain Grind Test
- positioning
- protocol
- what a positive indicates
patient in seated position with hand and fingers accessible and forearm stabilized
therapist holds patient’s hand and stabilizes trapezium with other hand on first metacarpal
– at CMC joint line, compress first metacarpal into trapezium
(+) = reproduction of symptoms
– mobility deficit test for OA at thumb CMC
explain Watson Scaphoid Test (the one Kaylan did not the one on PhysioU… btw)
- positioning
- protocol
- what a positive indicates
patient seated with elbow on the table and forearm in neutral position
- placed in slight extension and ulnar deviation
therapist stabilizes scaphoid with off hand
“shake” the patient’s hand
– bring the patient into radial deviation and slight flexion then release the scaphoid
(+) = palpable/audible clunk or reproduction of pain
– test for movement coordination
– integrity of scapholunate ligament
explain Allen’s Test
- positioning
- protocol
- what a positive indicates
patient seated with arm rested on table
therapist instructs patient to open/close their hand 10 times and to hold fist closed on 10th rep
– radial/ulnar arteries are compressed
patient opens hand and one of the arteries is released
–> count time it takes to refill hand
*** repeated with other artery on same hand
(+) = refill time > 2 sec
– vascular test
–> could be done to check blood flow if suspecting possible compartment syndrome, tight casting, peripheral artery disease
explain Press Test
- positioning
- protocol
- what a positive indicates
patient seated in a chair with arm rests
patient asked to push off of arm rests and suspend weight of body through hands
(+) = reproduction of ulnar sided wrist pain
– movement coordination test
– assessment of triangular fibrocartilage complex
