Apprehension Test
Original Editor - Tyler Shultz
Top Contributors - Admin, Tyler Shultz, Rachael Lowe, Kim Jackson, Evan Thomas, Scott Buxton, Naomi O'Reilly, Kai A. Sigel, WikiSysop, Claire Knott, Wanda van Niekerk and Mohamed A Hassanin
Purpose
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
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 in sagittal plane and 180 degrees in frontal plane (horizontal abduction), 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].
Evidence
| Test-retest reliability (intraclass correlation coefficient) | 0.74-0.84 (good) |
| 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.
Attention: If you are healthy and have the test applied on your shoulder with positive results, you have a great risk for developing shoulder dislocation in the future. [7]
See test diagnostics page for explanation of statistics.
References
- ↑ 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
- ↑ Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
- ↑ Cotter EJ, Hannon CP, Christian D, Frank RM, Bach BR. Comprehensive Examination of the Athlete’s Shoulder. Sports Health: A Multidisciplinary Approach. 2018 Feb 14;10(4):366–75.
- ↑ Apprehension (Crank) Test for Anterior Shoulder Dislocation | Shoulder Instability. Available from: https://www.youtube.com/watch?v=_JA-qvXcUdQ
- ↑ 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
- ↑ Rabin A, Ofir Chechik, Olds M, Uhl TL, Efi Kazum, Deutsch A, et al. The supine moving apprehension test—Reliability and validity among healthy individuals and patients with anterior shoulder instability. 2023 Apr 18;175857322311701-175857322311701.
- ↑ Owens BD, Campbell SE, Cameron KL. Risk factors for anterior glenohumeral instability. The American Journal of Sports Medicine [Internet]. 2014 Nov 1 [cited 2021 May 16];42(11):2591–6. Available from: https://pubmed.ncbi.nlm.nih.gov/25248922/