The Apprehension test is generally used to test the integrity of the glenohumeral joint capsule or to assess glenohumeral instability in an anterior direction.
In supine, the patient is positioned with the scapula supported by the sting of the examining table. The arm is positioned in 90 °abduction and external rotation. With increasing external rotation the examiner watches for apprehension on the part of the patient. This test is usually performed in sitting within the clinic setting and therefore the examiner exerts an anterior translatory force with their thumb placed posteriorly on the humerus. However, their fingers are anterior to regulate any sudden instability episode which will occur.
Essentially this test must produce a fear (see note regarding apprehension) response from the patient. Pain alone doesn’t = a positive test. within the case of a positive test then proceed to the relocation test. Record the quantity of external rotation achieved at the onset of Sx/response. A positive test is typically correlated with a labral lesion and/or bony lesion at the anterior inferior rim of the glenoid.
Meister (2000) reports a modification of the Apprehension test referred to as the Posterior Impingement sign. This places the jostle in the late cocking position. 90-100° abduction, 10-15° extension, and maximal external rotation. Reproduction of pain within the posterior aspect of the shoulder is bigger than 90% sensitive for the detection of tears to the posterior labrum and/or structure.
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