Execution
- 1Perform PROM when active range is limited or when end feel cannot be assessed during active testing.
- 2Passively move the shoulder complex through abduction, flexion, scaption, rotation, extension, adduction, and horizontal movements while comparing both sides.
- 3Stabilize the scapula and clavicle when isolating glenohumeral motion, especially during abduction and rotation.
- 4Note end feel, pain, capsular tightness, muscle tightness, apprehension, crepitus, and whether the restriction appears capsular or noncapsular.
- 5Assess posterior capsular tightness by stabilizing the scapula and moving the humerus into horizontal adduction, stopping when scapular motion or humeral rotation begins.
Positive outcome
Abnormal findings: painful PROM, restricted range, abnormal end feel, capsular or noncapsular pattern, or posterior capsular tightness.
Expected end-feels- Capsular pattern: external rotation most restricted, then abduction, then internal rotation
- Noncapsular pattern: movement loss does not follow that order
- Posterior capsular tightness: reduced horizontal adduction and reduced internal rotation with scapula stabilized
Shoulder PROM must consider glenohumeral, scapulothoracic, acromioclavicular, sternoclavicular, rib, and thoracic contributions. Diagnostic value comes from pattern recognition and end feel, not from PROM in isolation.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Riddle et al. (1987) | NA | NA | NA | NA | NA |
| Awan et al. (2002) | NA | NA | NA | NA | NA |
CommentPROM helps separate pain-limited active movement from passive joint or soft-tissue restriction. Magee stresses that shoulder PROM must consider the glenohumeral, scapulothoracic, acromioclavicular, sternoclavicular, rib, and thoracic contributions. Diagnostic value comes from pattern recognition and end feel, not from PROM as an isolated special test.