Execution
- 1Position the patient prone.
- 2Abduct the test arm to 90° and externally rotates the shoulder.
- 3Ask the patient to horizontally extend the arm.
- 4Apply resistance to horizontal extension.
- 5Watch whether scapular retraction occurs normally or whether the scapula protracts.
Positive outcome
Scapular protraction during resisted horizontal extension indicates weakness of the middle trapezius fibers. Pain or inability to hold the arm should be documented separately because pain inhibition may mimic weakness.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Brunnstrom (1941) | NA | NA | NA | NA | NA |
CommentMagee describes this as a scapular stabilizer strength test. It is clinically useful for scapular dyskinesis and shoulder-control assessment but does not diagnose rotator cuff tear. Use exact positioning because arm angle changes the contribution of other scapular muscles.