Overview
This lecture explains the Apley scratch test, a quick method to assess functional shoulder range of motion (ROM) and identify potential movement restrictions.
Apley Scratch Test Purpose
- The Apley scratch test quickly evaluates a patient's functional shoulder ROM.
- The test combines medial rotation with extension and adduction, and lateral rotation with flexion and abduction.
- These movements simulate daily activities like reaching for a back pocket or combing hair.
How to Perform the Test
- The patient tries to touch their hands together behind the back, one hand reaching from above and one from below.
- The patient repeats the movement with arms switched to compare both sides.
- Observe for differences between sides, as the dominant arm may show more restriction.
Interpreting Findings
- Restrictions observed during the test may not originate solely from the glenohumeral (shoulder) joint.
- Effective shoulder movement requires coordinated motion of the clavicle and scapula.
- Many shoulder issues stem from poor scapular muscle control, not just joint dysfunction.
Next Steps in Assessment
- If scapular muscle control is suspected, perform specific muscle tests for the shoulder girdle.
Key Terms & Definitions
- Apley scratch test — a physical exam maneuver for assessing functional shoulder range of motion.
- Medial rotation — rotating the arm inward toward the body's midline.
- Lateral rotation — rotating the arm outward away from the body's midline.
- Adduction — bringing the arm closer to the body.
- Abduction — moving the arm away from the body.
- Scapular muscle control — the ability of muscles around the scapula (shoulder blade) to coordinate movement.
Action Items / Next Steps
- Practice the Apley scratch test on patients and compare both sides.
- Assess scapular muscle control with additional shoulder girdle muscle tests if movement restriction is noted.
- Review key shoulder anatomy, especially movements involving the scapula and clavicle.