Execution
- 1Position the patient standing.
- 2Place one hand on the patient's abdomen below the xiphoid process to feel the pressure applied.
- 3Ask the patient to place the hand of the test shoulder over the examiner's hand and press into the abdomen.
- 4Ask the patient to bring the elbow forward into the scapular plane while maintaining pressure through the hand.
- 5Observe whether the wrist flexes, the shoulder extends, or abdominal pressure decreases.
Positive outcome
The test is positive if the patient cannot maintain pressure while bringing the elbow forward. Wrist flexion, shoulder extension, or loss of internal-rotation pressure suggests subscapularis dysfunction. Magee notes that a modified belly-press angle difference of 10° or more may also be considered positive.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Tokish et al. (2003) | NA | NA | NA | NA | NA |
| Barth et al. (2006) | NA | 40 | 97.9 | 19.05 | 0.61 |
| Jain et al. (2017) | NA | 28 | 87 | 2.15 | 0.83 |
CommentThe belly-press test is especially useful when the patient cannot get the hand behind the back for lift-off testing. Barth's high specificity produces a strong LR+, but sensitivity is low and later cohort data are more modest. A negative belly-press test should not be used to exclude subscapularis tear.
High Clinical Value