Load and Shift: Difference between revisions

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'''Original Editor '''- [[User:Tyler Shultz|Tyler Shultz]]  
'''Original Editor '''- [[User:Tyler Shultz|Tyler Shultz]]  


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== Purpose<br>  ==


This test is used to assess the stability of the [[Glenohumeral Joint|Glenohumeral joint]].<br>
== Purpose  ==


== Technique<ref>Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.</ref><br>  ==
This test is used to assess the stability of the [[Glenohumeral Joint|Glenohumeral joint]].  


The patient should be seated.&nbsp; The therapist stabilizes the scapula to the thorax with one hand, while the other hand is placed across the posterior [[Glenohumeral Joint|GH joint]] line and humeral head, and the web space across the patient's acromion.&nbsp; The index finger should the over the anterior [[Glenohumeral Joint|GH joint]] line.&nbsp; The clinician should now apply a "load and shift" of the humeral head across the stabilized scapula in an anteriomedial direction to assess anterior stability, and in a posteriolateral direction to assess posterior instability.&nbsp; Normal motion anteriorly is half of the distance of the humeral head, more movement is considered to be a sign of [[Glenohumeral Joint|GH joint]] laxity.<br>  
== Technique<ref>Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.</ref> ==


{| width="100%" cellspacing="1" cellpadding="1"
The patient should be seated. The therapist stabilizes the scapula to the thorax with one hand, while the other hand is placed across the posterior [[Glenohumeral Joint|GH joint]] line and humeral head, and the web space across the patient's acromion. The index finger should the over the anterior [[Glenohumeral Joint|GH joint]] line. The clinician should now apply a "load and shift" of the humeral head across the stabilized scapula in an anteromedial direction to assess anterior stability, and in a posterolateral direction to assess posterior instability. Normal motion anteriorly is half of the distance of the humeral head, more movement is considered to be a sign of [[Glenohumeral Joint|GH joint]] laxity.<br>
|-
 
| {{#ev:youtube|zuf09YtD_Kk|300}}<ref>Clinicially Relevant Technologies, http://www.youtube.com/watch?v=zuf09YtD_Kk; Accessed May 2011</ref>  
{{#ev:youtube|zuf09YtD_Kk|300}}<ref>Clinicially Relevant Technologies, http://www.youtube.com/watch?v=zuf09YtD_Kk; Accessed May 2011</ref>  
| {{#ev:youtube|uhBWu9TJsJ8|300}}<ref>Clinically Relevant Technologies, http://www.youtube.com/watch?v=uhBWu9TJsJ8; Accessed May 2011</ref>
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{{#ev:youtube|uhBWu9TJsJ8|300}}<ref>Clinically Relevant Technologies, http://www.youtube.com/watch?v=uhBWu9TJsJ8; Accessed May 2011</ref>


== Evidence  ==
== Evidence  ==
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<br>See [[Test Diagnostics|test diagnostics]] page for explanation of statistics.  
<br>See [[Test Diagnostics|test diagnostics]] page for explanation of statistics.  


== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
<div class="researchbox">
<rss>http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1vCeRl5tNk836xEe6LzxONGIEozeGAoaN9hZx_J-vJUnWFk5s|charset=UTF-8|short|max=10</rss>
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== References  ==
== References  ==


<references />  
<references />  


[[Category:Videos]]   [[Category:Special_Tests]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Shoulder]]
[[Category:Special_Tests]]
[[Category:Shoulder]]
[[Category:Shoulder - Special Tests]]  
[[Category:Shoulder - Assessment and Examination]]  
[[Category:Musculoskeletal/Orthopaedics]]
[[Category:Sports Medicine]]
[[Category:Athlete Assessment]]
[[Category:Assessment]]

Latest revision as of 20:52, 21 November 2019

Original Editor - Tyler Shultz

Top Contributors - Admin, Rachael Lowe, Tyler Shultz, Kim Jackson, Dan Rhon, WikiSysop, Tony Lowe, Evan Thomas, Naomi O'Reilly, Kai A. Sigel and Wanda van Niekerk

Purpose[edit | edit source]

This test is used to assess the stability of the Glenohumeral joint.

Technique[1][edit | edit source]

The patient should be seated. The therapist stabilizes the scapula to the thorax with one hand, while the other hand is placed across the posterior GH joint line and humeral head, and the web space across the patient's acromion. The index finger should the over the anterior GH joint line. The clinician should now apply a "load and shift" of the humeral head across the stabilized scapula in an anteromedial direction to assess anterior stability, and in a posterolateral direction to assess posterior instability. Normal motion anteriorly is half of the distance of the humeral head, more movement is considered to be a sign of GH joint laxity.

[2]

[3]

Evidence[edit | edit source]

Gerber & Ganz report this test to be 100% sensitive for the detection of instability in patients with recurrent dislocation, but not subluxation.[4]


See test diagnostics page for explanation of statistics.

References[edit | edit source]

  1. ↑ Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
  2. ↑ Clinicially Relevant Technologies, http://www.youtube.com/watch?v=zuf09YtD_Kk; Accessed May 2011
  3. ↑ Clinically Relevant Technologies, http://www.youtube.com/watch?v=uhBWu9TJsJ8; Accessed May 2011
  4. ↑ Gerber, C., Ganz, R. (1984) Clinical assessment of instability of the shoulder. J Bone and Joint Surg. 66B:551.
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