Gravity Resisted Instructions: Stand behind client (while seated), stabilize opposite shoulder. Ask the client to "Shrug your shoulder and don't let me push you down." The client will eleveate the scapula as practitioner pushes downward.
Grades: Normal (5), Good (4), Fair (3)
Gravity Minimized: No resistance is applied, practitioner supports the testing extremity. (Not pictured)
Instructions: Client is prone, upper extremities by their side. Practioner asks client to "shrug your shoulder." Assess the motion of the client elevating the scapula.
Palpate the functional muscle movers of the scapula (Levator scapulae, upper fibers of trapezius & Rhomboids)
Grades: Poor (2), Trace (1), No contraction (0)
Gravity Resisted Instructions: Stand behind client (while seated), stabilizing the shoulder. Ask the client to "Drop your shoulder pressing it down toward the ground. Don't let me push it up." The practitioner will cup thier hand below the inferior angle of the scapula and apply resistance upward in the direction of scapula elevation.
Grades: Normal (5), Good (4), Fair (3)
Gravity Minimized: No resistance is applied, practitioner supports the testing extremity. (Not pictured)
Instructions: Client is prone, upper extremities by their side. Practioner asks client to "press your shoulder blade down as you reach for the floor." Assess the motion of the client depressing the scapula.
Palpate the functional muscle movers of the scapula depressors (lower fibers of trapezius).
Grades: Poor (2), Trace (1), No contraction (0)
Gravity Resisted Instructions: Ask the client to lie prone with the shoulder abducted to 90 ° and elbow flexed to 90 ° and hanging over the edge of the plinth table. The head should be turned away from the testing side. Stand next to the client while stabilizing the opposite shoulder. Ask the client to "raise your elbow toward the ceiling and don't let me push you down." The client will retract (adduct) the scapula while the practitioner will apply resistance in the direction of scapula protraction.
Grades: Normal (5), Good (4), Fair (3)
Gravity Minimized: No resistance is applied, and the practitioner supports the testing extremity. (Not pictured)
Instructions: Client is seated in a chair with the upper extremity supported. Shoulder abducted and elbow flexed in 90* position. The practitioner stands next to the client and asks them to "squeeze both shoulder blades together." Assess the motion of the client adducting the scapula. Palpate the functional muscle movers of the scapula retractors (middle fibers of trapezius & rhomboid major and minor).
Grades: Poor (2), Trace (1), No contraction (0)
Gravity-Resisted Instructions: The client should be positioned in a supine position with the arm raised at 90 ° of shoulder flexion and the elbow extended. The practitioner will stand next to the client with their testing hand on the distal humerus and opposite hand stabilizing the opposite shoulder. Ask the client to "Reach for the ceiling and do not let me push your arm down." The practitioner will apply resistance to the arm at the distal humerus and push the scapula into retraction (adduction).
Grades: Normal (5), Good (4), Fair (3)
Gravity Minimized: No resistance is applied, the practitioner supports the testing extremity, or it is resting on a table.. (Not pictured)
Instructions: Client is seated at the table with the upper extremity supported on the table in front of them, with the shoulder flexed at 90°. Practitioner asks client to "reach your arm forward." Assess the motion of the client depressing the scapula.
Palpate the functional muscle movers of the scapula protractors (serratus anterior & pectoralis minor).
Grades: Poor (2), Trace (1), No contraction (0)
Gravity Resisted Instructions: Ask the client to sit in a chair with their back supported. The practitioner will stabilize the scapula and then ask the client to "raise arm out in front of you and don't let me push you down." The client will move the shoulder into flexion, and the practitioner applies resistance in the mid humerus in the direction of extension.
Grades: Normal (5), Good (4), Fair (3)
Gravity Minimized: No resistance is applied, and the practitioner supports the testing extremity. (Not pictured)
Instructions: Client is in side-lying on the non-tested side. The arm being tested will be supported by the practitioner. The practitioner will ask the client to "raise your arm out in front of you as far as you can go." The practitioner will palpate the functional muscle movers of the shoulder flexors (anterior deltoid, coracobrachialis, and pectoralis major).
Grades: Poor (2), Trace (1), No contraction (0)
Gravity Resisted Instructions: Ask the client to sit in a chair with their back supported. The practitioner will stabilize the scapula and stand by their side. The practitioner will ask the client to "reach your arm back behind you as far as you can and don't let me push you down." The client will move the shoulder into extension, and the practitioner applies resistance in the mid humerus in the direction of flexion.
Grades: Normal (5), Good (4), Fair (3)
Gravity Minimized: No resistance is applied, and the practitioner supports the testing extremity. (Not pictured)
Instructions: Client is in side-lying on the non-tested side. The arm being tested will be supported by the practitioner. The practitioner will ask the client to "reach your arm behind you as far as you can go." The practitioner will palpate the functional muscle movers of the shoulder extensors (latissimus dorsi, teres major, posterior fibers of deltoid, triceps).
Grades: Poor (2), Trace (1), No contraction (0)
Gravity Resisted Instructions: Ask the client to sit in a chair with their back supported and the testing arm is relaxed, neutral, and extended. The practitioner will stand behind the client on the same side and stabilize the shoulder. The practitioner will ask the client to "Raise your arm out to the side about shoulder height and don't let me push you down." The client will move the shoulder into abduction, and the practitioner applies resistance in the mid humerus in the direction of adduction.
Grades: Normal (5), Good (4), Fair (3)
Gravity Minimized: No resistance is applied, and the practitioner supports the testing extremity. (Not pictured)
Instructions: Client is supine. The arm being tested will be supported by the practitioner. The practitioner will ask the client to "try and bring your arm out to the side." The practitioner will palpate the functional muscle movers of the shoulder abductors (middle fibers of the deltoid, supraspinatus).
Grades: Poor (2), Trace (1), No contraction (0)
Gravity Resisted Instructions: Ask the client to sit in a chair with their back supported. The practitioner will stabilize the scapula and stand by their side. The practitioner will ask the client to "bring your arm out to your side at a 45° angle. Then, bring your arm down to your side and don't let me pull your arm upward." The client will move the shoulder into adduction, and the practitioner applies resistance in the proximal humerus in the direction of abduction.
Grades: Normal (5), Good (4), Fair (3)
Gravity Minimized: No resistance is applied, and the practitioner supports the testing extremity. (Not pictured)
Instructions: Client is in side-lying on the non-tested side. The arm being tested will be supported by the practitioner. The practitioner will ask the client to "reach your arm behind you as far as you can go." The practitioner will palpate the functional muscle movers of the shoulder extensors (teres major, latissimus dorsi, pectoralis major).
Grades: Poor (2), Trace (1), No contraction (0)
°
Gravity Resisted Instructions: Ask the client to lie supine with their testing arm abducted to and elbow flexed to 90°. The practitioner will stand next to the client and stabilize the shoulder. The practitioner will ask the client to "Raise your arm and reach across to your opposite shoulder, and don't let me pull your arm down." The client will move the shoulder into horizontal adduction, and the practitioner applies resistance in the distal humerus in the direction of horizontal abduction.
Grades: Normal (5), Good (4), Fair (3)
Gravity Minimized: No resistance is applied, and the practitioner supports the testing extremity. (Not pictured)
Instructions: Client is seated with the testing arm supported on a table with the shoulder abducted to 90°, elbow flexed, and forearm pronated. The practitioner will ask the client to "try to move your arm and reach to touch your opposite shoulder." The practitioner will palpate the functional muscle movers of the shoulder horizontal adductors (pectoralis major and anterior deltoid).
Grades: Poor (2), Trace (1), No contraction (0)
Gravity-Resisted Instructions: Ask the client to lie prone with their testing arm abducted to 90° and elbow flexed to 90°, and forearm and hand hanging off the table. The practitioner will stand next to the client and stabilize the shoulder and scapula. The practitioner will ask the client to "Raise your elbow toward the ceiling and don't let me push your arm down." The client will move the shoulder into horizontal abduction, and the practitioner applies resistance in the distal humerus in the direction of horizontal adduction.
Grades: Normal (5), Good (4), Fair (3)
Gravity Minimized: No resistance is applied, and the practitioner supports the testing extremity. (Not pictured)
Instructions: The client is seated with the testing arm supported on a table, the shoulder abducted to 90°, the elbow flexed, and the forearm pronated. The practitioner will ask the client to "Try to move your arm behind you." The practitioner will palpate the functional muscle movers of the shoulder abductors (posterior deltoid, teres minor, & infraspinatus).
Grades: Poor (2), Trace (1), No contraction (0)
Gravity-Resisted Instructions: Ask the client to lie prone with their testing arm abducted to 90° and elbow flexed to 90°, and forearm and hand hanging off the table. Place a rolled towel under the humerus to support proper positioning of the shoulder. The practitioner will stand next to the client and stabilize the humerus. The practitioner will ask the client to "Move your palm side of the hand toward the ceiling and don't let me push your arm down." The client will move the shoulder into internal rotation, and the practitioner applies resistance in the distal humerus in the direction of external rotation.
Grades: Normal (5), Good (4), Fair (3)
Gravity Minimized: No resistance is applied, and the practitioner supports the testing extremity. (Not pictured)
Instructions: The client is seated with the testing arm supported at their side, elbow flexed to 90°, the forearm neutral. The practitioner will ask the client to " Bring your hand in toward your stomach." The practitioner will palpate the functional muscle movers of the shoulder internal rotators (subscapularis, teres major, pectoralis major, latissimus dorsi, anterior deltoid).
Grades: Poor (2), Trace (1), No contraction (0)
Gravity-Resisted Instructions: Ask the client to lie prone with their testing arm abducted to 90° and elbow flexed to 90°, and forearm and hand hanging off the table. Place a rolled towel under the humerus to support proper positioning of the shoulder. The practitioner will stand next to the client and stabilize the humerus. The practitioner will ask the client to "Move your arm up toward the ceiling and don't let me push your arm down." The client will move the shoulder into external rotation, and the practitioner applies resistance in the distal humerus in the direction of internal rotation.
Grades: Normal (5), Good (4), Fair (3)
Gravity Minimized: No resistance is applied, and the practitioner supports the testing extremity. (Not pictured)
Instructions: The client is seated with the testing arm supported at their side, elbow flexed to 90°, the forearm neutral. The practitioner will ask the client to " Bring your hand out and away from your body." The practitioner will palpate the functional muscle movers of the shoulder external rotators (infraspinatus, teres minor, posterior fibers of the deltoid).
Grades: Poor (2), Trace (1), No contraction (0)