Execution:
- The patient is in sitting position with the examiner positioned behind them and the patient leaning against the examiner
- The examiner locates spinous process T1 for orientation and rotates the patient’s head towards the side to be examined
- The patient’s head is flexed laterally towards the side to be examined to relax the trapezius muscle and the examiner fixates this position by placing the elbow against the patient’s sternum
- The examiner then places the MCP1 on the first rib an assesses mobility by pushing into caudal, ventral and medial direction while the patient breathes out
Positive Outcome: Pain provocation or change in end feel compared with the other side
| Study | Reliability | Sn | Sp | LR+ | LR- |
| Fjellner et al. (1999) | Inter к=0.06 | NA | NA | NA | NA |
