Apprehension Test: Difference between revisions

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== Expert Opinion  ==
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'''Original Editor '''- [[User:Tyler Shultz|Tyler Shultz]]


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== Purpose ==
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== Purpose<br> ==
The Apprehension test is generally used to test the integrity of the [[Glenohumeral Joint|glenohumeral]] joint capsule, or to assess [[Shoulder Instability|glenohumeral instability]] in an anterior direction.<br>


The Apprehension test is generally used to test the integrity of the [[The_Glenohumeral_Joint|glenohumera]]l joint capsule, or to assess [[Shoulder_Instability|glenohumeral instability]].<br>
== Technique ==


== Technique<br> ==
The patient should be position in supine.&nbsp; The therapist will flex the patient's elbow to 90 degrees and abducts the patient's shoulder to 90 degrees, maintaining neutral rotation.&nbsp; The examiner then slowly applies an external rotation force to the arm to 90 degrees while carefully monitoring the patient<ref>Flynn, T.W., Cleland, J.A., Whitman, J.M. (2008). User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. Buckner, Kentucky: Evidence in Motion</ref>.&nbsp; Patient apprehension from this maneuver, not pain, is considered a positive test.&nbsp; Pain with the maneuver, but not apprehension may indicate a pathology other than instability, such as posterior impingement of the rotator cuff<ref>Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.</ref>.<br>  


The patient should be position in supine.&nbsp; The therapist will flex the patient's elbow to 90 degrees and abducts the patient's shoulder to 90 degrees, maintaining neutral rotation.&nbsp; The examiner then slowly applies an external rotation force to the arm to 90 degrees while carefully monitoring the patient<ref>Flynn, T.W., Cleland, J.A., Whitman, J.M. (2008). User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. Buckner, Kentucky: Evidence in Motion</ref>.&nbsp; Patient apprehension from this maneuver, not pain, is considered a positive test.&nbsp; Pain with the maneuver, but not apprehension may indicate a pathology other than instability, such as posterior impingement of the rotator cuff<ref>Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.</ref>.<br>
{{#ev:youtube|_JA-qvXcUdQ}}<ref>Apprehension (Crank) Test for Anterior Shoulder Dislocation | Shoulder Instability. Available from: https://www.youtube.com/watch?v=_JA-qvXcUdQ</ref>


== Evidence  ==
== Evidence  ==
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<br>
'''Test Item Cluster:''' If found positive, the Apprehension test is often combined with the [[Jobes Relocation Test|Jobes Relocation test]].


'''Test Item Cluster:''' If found positive, the Apprehension test is often combined with the [[Jobes Relocation Test|Jobes Relocation test]].
See [[Test Diagnostics|test diagnostics]] page for explanation of statistics.  


== References<br> ==
== References  ==


<references />  
<references />  


<br> <br>
[[Category:Special_Tests]]
[[Category:Shoulder]]
[[Category:Shoulder - Special Tests]]
[[Category:Shoulder - Assessment and Examination]]
[[Category:Musculoskeletal/Orthopaedics]]
[[Category:Rehabilitation Foundations]]
[[Category:Sports Medicine]]
[[Category:Athlete Assessment]]
[[Category:Assessment]]

Latest revision as of 20:22, 21 November 2019

Original Editor - Tyler Shultz

Top Contributors - Admin, Tyler Shultz, Rachael Lowe, Kim Jackson, WikiSysop, Claire Knott, Wanda van Niekerk, Evan Thomas, Scott Buxton, Naomi O'Reilly and Kai A. Sigel

Purpose[edit | edit source]

The Apprehension test is generally used to test the integrity of the glenohumeral joint capsule, or to assess glenohumeral instability in an anterior direction.

Technique[edit | edit source]

The patient should be position in supine.  The therapist will flex the patient's elbow to 90 degrees and abducts the patient's shoulder to 90 degrees, maintaining neutral rotation.  The examiner then slowly applies an external rotation force to the arm to 90 degrees while carefully monitoring the patient[1].  Patient apprehension from this maneuver, not pain, is considered a positive test.  Pain with the maneuver, but not apprehension may indicate a pathology other than instability, such as posterior impingement of the rotator cuff[2].

[3]

Evidence[edit | edit source]

Diagnostic Test Properties for the Apprehension Test[4]
Sensitivity   0.53
Specificity   0.99
Positive Likelihood Ratio   53.0
Negative Likelihood Ratio   0.47

Test Item Cluster: If found positive, the Apprehension test is often combined with the Jobes Relocation test.

See test diagnostics page for explanation of statistics.

References[edit | edit source]

  1. ↑ Flynn, T.W., Cleland, J.A., Whitman, J.M. (2008). User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. Buckner, Kentucky: Evidence in Motion
  2. ↑ Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
  3. ↑ Apprehension (Crank) Test for Anterior Shoulder Dislocation | Shoulder Instability. Available from: https://www.youtube.com/watch?v=_JA-qvXcUdQ
  4. ↑ Flynn, T.W., Cleland, J.A., Whitman, J.M. (2008). User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. Buckner, Kentucky: Evidence in Motion
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