Apprehension Test | Anterior Instability

Execution:

  1. Patient is in supine lying position
  2. The patient’s shoulder is brought into 90° of abduction
  3. The examiner brings the shoulder into maximal external rotation with caution

 

Positive Outcome: Patient reports fear of luxation and will not allow the examiner to move further into external rotation

Study Reliability Sn Sp LR+ LR-
Hegedus et al. (2012) NA 65.6 95.4 17.21 0.39
Tzannes et al. (2004)
apprehension
Inter-rater ĸ=0.47 NA NA NA NA
Eshoj et al. (2018)
pain or apprehension
Inter-rater ĸ=0.65 NA NA NA NA
The Apprehension Test can be used to rule in/confirm anterior instability. Biomechanically it makes more sense to horizontally abduct to have the head of the humerus glide anteriorly.