Test Your Upper Limb Assessment Skills as a Physiotherapist

Assessment of Upper Limb Pathology in Physiotherapy

• The upper limb, including the shoulder, elbow, and wrist-hand, have a high prevalence of pathology and disability among the working population and students (30%-53%).
• Shoulder pathology includes impingement, rotator cuff tears, dislocations, instability, labral tears, sprains, arthritis, frozen shoulder, fractures, and more.
• Visual inspection is an essential part of shoulder assessment, looking for swelling, skin discoloration, muscle atrophy, scars, deformity/abnormal posture, and winging of the scapulae.
• Range of motion assessment for the shoulder involves active/passive movements that produce or increase symptoms and are restricted in the same direction and at the same point in the range for noncontractile dysfunction, while passive joint play movements are normal and symptom-free for contractile dysfunction.
• Intraexaminer reliability for shoulder range of motion is high for flexion, external rotation, internal rotation, and abduction (CCI > 0.94), while interexaminer reliability varies (CCI > 0.27-0.89).
• Apley's Scratch Test for Shoulder Mobility involves bilateral assessment of three actions, testing glenohumeral adduction, internal/external rotation, horizontal adduction/abduction, scapular protraction/upward rotation/elevation/retraction with downward rotation.
• Muscle testing is crucial for upper limb neurogenic pain assessment.
• Shoulder orthopaedic tests include the Neer test for subacromial impingement, the Painful arc test for rotator cuff lesion, the Jobe test for supraspinatus tear, the Aprehension test and Jobe relocation test for anterior glenohumeral instability, the Hornblower test for infraspinatus/teres minor tear, and the Lift-off test for subscapularis tear.
• Elbow range of motion assessment has high intraexaminer reliability (CCI > 0.8-0.9) and interexaminer reliability (CCI > 0.8).
• Wrist range of motion assessment also has high intraexaminer reliability (CCI = 0.8-0.9) and interexaminer reliability (CCI = 0.8-0.9).
• Elbow orthopaedic tests include the Cubital tunnel syndrome test, involving 60 seconds pressure on the ulnar nerve, and the Tinel's sign, tapping over the nerve.
• The Disabilities of the Arm, Shoulder, and Hand (DASH) is a reliable 30-item self-report questionnaire that measures physical function and symptoms in people with any musculoskeletal disorder of the upper limb.

Assessment of Upper Limb Pathology in Physiotherapy

• The upper limb, including the shoulder, elbow, and wrist-hand, have a high prevalence of pathology and disability among the working population and students (30%-53%).
• Shoulder pathology includes impingement, rotator cuff tears, dislocations, instability, labral tears, sprains, arthritis, frozen shoulder, fractures, and more.
• Visual inspection is an essential part of shoulder assessment, looking for swelling, skin discoloration, muscle atrophy, scars, deformity/abnormal posture, and winging of the scapulae.
• Range of motion assessment for the shoulder involves active/passive movements that produce or increase symptoms and are restricted in the same direction and at the same point in the range for noncontractile dysfunction, while passive joint play movements are normal and symptom-free for contractile dysfunction.
• Intraexaminer reliability for shoulder range of motion is high for flexion, external rotation, internal rotation, and abduction (CCI > 0.94), while interexaminer reliability varies (CCI > 0.27-0.89).
• Apley's Scratch Test for Shoulder Mobility involves bilateral assessment of three actions, testing glenohumeral adduction, internal/external rotation, horizontal adduction/abduction, scapular protraction/upward rotation/elevation/retraction with downward rotation.
• Muscle testing is crucial for upper limb neurogenic pain assessment.
• Shoulder orthopaedic tests include the Neer test for subacromial impingement, the Painful arc test for rotator cuff lesion, the Jobe test for supraspinatus tear, the Aprehension test and Jobe relocation test for anterior glenohumeral instability, the Hornblower test for infraspinatus/teres minor tear, and the Lift-off test for subscapularis tear.
• Elbow range of motion assessment has high intraexaminer reliability (CCI > 0.8-0.9) and interexaminer reliability (CCI > 0.8).
• Wrist range of motion assessment also has high intraexaminer reliability (CCI = 0.8-0.9) and interexaminer reliability (CCI = 0.8-0.9).
• Elbow orthopaedic tests include the Cubital tunnel syndrome test, involving 60 seconds pressure on the ulnar nerve, and the Tinel's sign, tapping over the nerve.
• The Disabilities of the Arm, Shoulder, and Hand (DASH) is a reliable 30-item self-report questionnaire that measures physical function and symptoms in people with any musculoskeletal disorder of the upper limb.

Are you a physiotherapist looking to enhance your assessment skills for upper limb pathology? Take this quiz to test your knowledge on shoulder, elbow, and wrist-hand assessments. From range of motion to orthopaedic tests, this quiz covers essential components of upper limb assessments, including muscle testing and the use of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Sharpen your skills and learn new techniques to better serve your patients with upper limb pathologies.