Load and Shift Test | Anterior+Posterior Instability

Execution:

  1. Patient is in sitting with straight posture and arms resting on the thighs
  2. The examiner stabilizes the clavicle and scapula with one hand and grabs on to the humeral head with the other hand
  3. Load portion: Positioning the humeral head in the glenoid fossa
  4. Shift portion: Translating the humeral head forward (anterior capsule) and afterwards translating it backwards (posterior capsule)

 

Positive Outcome: Increased translation compared to the other side (normal: 25% of translation of the humeral head diameter anterior and 50% of the humeral head diameter posterior) and reproduction of patient’s symptoms

Study Reliability Sn Sp LR+ LR-
Morey et al. (2016) NA 37.5 89.2 3.47 0.7
Tzannes et al. (2004)
90° ABD, anterior
Inter-rater ICC=0.72 NA NA NA NA
Tzannes et al. (2004)
0° ABD, posterior
Inter-rater ICC=0.68 NA NA NA NA
Tzannes et al. (2004)
0° ABD, inferior
Inter-rater ICC=0.79 NA NA NA NA
Eshoj et al. (2018)
Laxity score 2 or 3
Inter-rater ĸ=0.48 NA NA NA NA