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Apprehension Test

Anterior Instability

Source: Physiotutors

Execution

  1. 1Position the patient sitting or supine with the shoulder relaxed.
  2. 2Abduct the shoulder to approximately 90°.
  3. 3Slowly externally rotate the shoulder toward end range.
  4. 4Apply a gentle anteriorly directed force to the posterior humeral head to increase anterior translation.
  5. 5Stop if the patient becomes apprehensive or resists further motion.

Positive outcome

The test is positive when the patient shows apprehension, alarm, or resistance because the shoulder feels as if it may dislocate. Pain alone is not the best positive criterion for anterior instability and may reflect internal impingement or cuff / labral pain.

Studies

StudyReliabilitySnSpLR+LR−
Lo et al. (2004)NANANANANA

CommentMagee emphasizes that apprehension should predominate over pain; testing too quickly can provoke dislocation. The test is most useful in traumatic anterior instability and less useful when the chief complaint is nonspecific pain. Combine it with relocation and surprise testing for stronger rule-in value.

Moderate Clinical Value

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