From the Research
The shoulder range of motion exam is also commonly referred to as the Apley scratch test, although the provided evidence does not directly support this specific name, it is a widely recognized term in clinical practice. This clinical assessment evaluates a patient's shoulder mobility by having them perform specific movements that test both internal and external rotation, as well as adduction and abduction capabilities. During the test, patients are asked to reach behind their back and up toward the opposite shoulder blade (testing internal rotation and adduction), and then to reach behind their head to touch the upper back between the shoulder blades (testing external rotation and abduction). The test is valuable because it provides a functional assessment of shoulder mobility that correlates with everyday activities like dressing, grooming, and reaching. No special equipment is needed to perform this test, making it a practical tool for clinicians to quickly evaluate shoulder function in various settings. Limitations in any direction of movement can help identify specific shoulder pathologies such as rotator cuff injuries, adhesive capsulitis (frozen shoulder), or arthritis affecting the glenohumeral joint.
Some studies have focused on the reliability and methods of measuring shoulder range of motion, such as using a goniometer versus a digital level 1, or assessing the range of motion required for daily activities 2. For instance, a study published in the Journal of Shoulder and Elbow Surgery in 2012 found that the average shoulder motions required to perform functional tasks were flexion, 121° ± 6.7°; extension, 46° ± 5.3°; abduction, 128° ± 7.9°; cross-body adduction, 116° ± 9.1°; external rotation with the arm 90° abducted, 59° ± 10°; and internal rotation with the arm at the side, 102° ± 7.7° 2.
Other research has explored the development of novel indices for measuring shoulder mobility 3 and the reliability of shoulder range of motion comparing different measurement tools 1. A study from 2010 described clinical shoulder complex range of motion measures for a young, healthy, and physically active population, providing baseline data for future comparisons 4. Additionally, a study from 2008 introduced a novel patient self-assessment tool for shoulder range of motion, showing that patients can accurately assess their own active shoulder range of motion using a diagram-based questionnaire 5.
Key points to consider when evaluating shoulder range of motion include:
- The importance of functional assessment in relation to daily activities
- The use of reliable measurement tools, such as goniometers or digital levels
- The consideration of bilateral and sex differences in range of motion
- The definition of functional range of motion for activities of daily living
Overall, while the specific name "Apley scratch test" may not be directly supported by the provided evidence, the concept of assessing shoulder range of motion through functional movements is widely recognized and valuable in clinical practice, as supported by studies such as 3, 5, 1, 4, 2.