Name of test
Shoulder abduction
What it tests
The extent of active abduction.
How to do it
- stand behind the patient
- ask the patient to bring up both arms in the coronal plane, "like airplane wings."
- If the patient cannot do this actively, gently assist, and measure passive motion
The normal response
About 160 degrees.
What it means if not normal
The joint may be constricted or it may be painful. Note also differences between active and passive motion. The loss of active but not passive motion implies a rotator cuff problem. (It also could be a deltoid problem, but less likely.) If the restrictions are both active and passive, the joint is either contracted or arthritic.
Comments
Note that even if the gleno-humeral joint were fused, some motion, via scapulothoracic substitution, can occur.
If the patient does not externally rotate the arm (palms up) while doing this, the greater tuberosity may block motion.
Citations
Bernstein J, 2004 Mar-Apr. "Evidence-based medicine." J Am Acad Orthop Surg 12 (2): 80-8 [PubMed]
Abstract:
Evidence-based medicine refers to an explicit process of using and evaluating information to make medical decisions. Evidence-based medicine, perhaps contrary to popular perception, requires its users to embrace uncertainty in medical decision making because information that is simultaneously true and complete cannot be attained. Recognizing medicine's inherent uncertainty, proponents of evidence-based medicine advocate using a five-step process for sound decision making: formulate answerable questions, gather evidence, appraise the evidence, implement the valid evidence, and evaluate the process. The formulation of answerable questions requires categorizing the facts of the case in terms that allow comparison to evidence gathered from prior studies. The appraisal of the evidence uses the tools of clinical epidemiology to assess the validity and applicability of the evidence. Implementation refers to the construction of a clinical plan based on the evidence collected as well as on the physician's judgment and patient's preferences. Finally, evidence-based medicine requires continued evaluation and refinement. The methods of evidence-based medicine are especially germane to contemporary medicine as physicians practice under increasing demands to deliver optimal outcomes yet face an ever-expanding body of medical knowledge.
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