Execution
- 1Perform passive testing if active range is limited or if overpressure / end feel is required.
- 2Passively flex and extend the elbow while stabilizing the arm and comparing the opposite side.
- 3Passively supinate and pronate the forearm while preventing shoulder compensation.
- 4Record normal or abnormal end feel for each movement.
- 5Check whether the pattern fits the elbow capsular pattern, with flexion more limited than extension.
Positive outcome
Abnormal findings: pain, loss of passive range, abnormal end feel, or a capsular pattern.
Expected end-feels- Flexion: tissue approximation (bone-to-bone in thin patients)
- Extension: bone-to-bone
- Supination: tissue stretch
- Pronation: tissue stretch (bone-to-bone in thin patients)
The elbow capsular pattern is greater limitation of flexion than extension. End-feel reliability is mixed, especially for flexion, so do not overinterpret subtle side-to-side differences.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Magee eAppendix 6.1 reference 140 | inter-examiner κ = 0.40 flexion; κ = 0.73 extension end-feel classification | NA | NA | NA | NA |
CommentPROM is an impairment and end-feel assessment rather than a disease-specific diagnostic test. Magee emphasizes careful passive testing when active movement is limited and comparison with the other side. End-feel reliability is mixed, especially for flexion, so do not overinterpret subtle differences.
Low Clinical Value