Execution
- 1Position the patient standing and stand behind the patient on the tested side.
- 2Place the fingers of one hand over the clavicle with the heel of the hand over the scapular spine to stabilize the clavicle and hold the scapula retracted.
- 3Use the other hand to contact the inferior angle of the scapula.
- 4As the patient actively abducts or forward flexes the arm, examiner assists scapular upward rotation by pushing the inferior medial border of the scapula upward and laterally while maintaining retraction.
- 5Compare the patient’s pain, range, and ease of elevation with and without assistance; the test may be repeated with or without hand weights if tolerated.
Positive outcome
The SAT is positive when manual scapular assistance decreases the patient’s familiar pain or improves the comparable elevation movement. The positive finding is symptom change, not proof of one structural lesion. Magee states that the assistance simulates serratus anterior and lower trapezius action during elevation.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Rabin et al. (2006) | acceptable intertester reliability | NA | NA | NA | NA |
| Seitz et al. (2012) | NA | NA | NA | NA | NA |
| Kopkow et al. (2015) | reliable for clinical use | NA | NA | NA | NA |
CommentSAT is a symptom-modification test for scapular contribution to painful elevation, especially in impingement-like presentations. A positive test suggests that altering scapular mechanics changes symptoms, but it does not diagnose serratus anterior weakness, lower trapezius weakness, or subacromial pathology by itself. Use it to guide exercise / manual correction choices and to demonstrate modifiability.
Low Clinical Value