Special Tests. Shoulder 2.

Question 1

Standard Values for AROM:

Answer 1

F: 160-180
E: 50-60
Abd: 170-180
Add: 50-75
Hor. Add:130
Ext. Rot: 80-90
Int. Rot: 60-100 (top of thumb reaches T5-T10)

Question 2

What is the goal of PROM?

Answer 2

End-feel to determing what is limiting full range of motion.

Question 3

What is normal end-feel?

Answer 3

Hard (ligamentous) : elbow ext.
Soft tissue approximation : Knee Flex.
Tissue stretch : Ankle dorsifl.

Question 4

What is abnormal end-feel ?

Answer 4

Early muscle spasm
Late muscle spasm
Mushy tissue stretch
–> οίδημα ή υπερβολική υγρότητα στην άρθρωση
Spasticity
Hard capsular
Soft capsular
Bone to bone
Empty (due to pain)
–> η κίνηση απλά σταματά λόγω πόνου, δεν υπάρχει end-feel
Springy block ( ξαφινκή διακοπή κίνησης σαν να υπάρχει ελατήριο, σαν να υπάρχει ελεύθερος χόνδρος ή ινώδης σχηματισμός )

Question 5

Normal end-feel for GH:

Answer 5

Abd: hard or tissue strech
Hor.Add : Tissue strech
Fl: Tissue Stretch
Ext: Tissue Strech
IR + AR: Tissue Strech

Note: Fixate GH !!

Question 6

Resisted Isometric Testing

Answer 6

Fl
Ex
Abd
Add
Ir
Ar
Elbow Fl
Elbow Ex

Question 7

Answer 7

Stenvers Test I
Backward Tilting of the scapula

Ex: Maximal Flexion
Compare the position of the axillar hair line with the angulus inferior

Pos: if the inerior angula is not in line and behind the XLR hairline

Question 8

Answer 8

Stenvers T II :
Clavicular Rotation

Ex: Palpate movement of Clavicular while doing full Flexion

Pos: Clavicle deviates from the normal pattern
–> until 45° elevation, anterior rot.
After 45° moves downwards, posterior ror.

Question 9

Answer 9

Stenvers T. III
Scapular Depression

Ex: palpate angulus inferior and follow Flex.

Pos: Scapula does not depress from 170° until full flexion(about 1-2cm).

–> pectoralis minor tightness
–> upper trapezius overactive
–> weak lower trapezius or serratus

Question 10

MRC scale
Oxford scale

Answer 10

Oxford with - and +

Question 11

Answer 11

Stenvers Test V
Posterior Capsule of the GH Joint, SC+AC Joint.

Ex : step 1: fixate scapula move to hor. Add.
Step 2. Let go and do hor. Add

Pos: step 1: less than 100°
Step 2: less than 120°

Question 12

Answer 12

GIRD
GH internal Rotation Deficit

Ex: palpate coracoid process to prevent scapular movement
Measure Ir and Ar in both sides.

Pos: Loss of >10° in Ir and loss of >10° in total ROM between sides (135-180).
The second ist more important!

Question 13

Answer 13

Proprioception T

Ex: 1 meter away from wall, laser.
Do x3 flexion, abd, Ir
Pos: 10% diference between sides.

Question 14

TOS Syndrome

Answer 14

Roos T
Adson T
ULTT 1

Question 15

Answer 15

Roos Test

Ex : 90 Abd, ER, 90 Elbow Fl
–> open close fingers for 3 min.

Pos : heaviness, ischemic pain or weakness of the arms, or numbness and tingling of the hands.
Discolaration of the hands ?

Not positov: Minor fatigue and distress.

Question 16

Answer 16

Adson T.
Για αρτηριακή μορφή!

Ex: GH slight ABD, ER, Extension
Palpate radial pulse –> Neck Rotation to the Tested Shoulder
Breath in and hold the breath.

Pos: Reproduction of patient Sy. Or abolition of the radial pulse

Question 17

Answer 17

Stenvers Test IV:
Thoracic Mobility C7-T4

Ex: Palpate the contralateral side of the dornfortsatz then dory GH Flexion

Pos: No rotation of spinous process of C7-T4 against their fingers from 160° Fl to full anteflexion.

Question 18

Answer 18

Posterior Impingement Sign

(Internal Shoulder Impingement)

Ex: 90-110° of abduction, 10-15° extension and maximal Ex. Rotation

Pos: provocation of pstients familiar deep posterior shoulder pain.