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Sec 3 clinical

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Special test Apley Scratch Test Ask the patient to bring one hand behind the head and reach for the superior border of the scapula on the opposite side. This movement combines abduction and external rotation. Then ask the patient to bring the opposite hand behind the back and reach up to touch the contralateral inferior angle of the scapula. This movement combines adduction and internal rotation. Then have the patient reverse the movements to observe the combination bilaterally Clinical continued ..... Dynamic Closed-Chain Stabilization Exercises it requires the stabilizing muscles to maintain control of the scapula and GH joint while moving the body weight over the fixed extremity or extremities. Patient position and procedure: Standing with shoulders flexed 90 and hands supported against a wall, leaning hands on a table, or assuming a quadruped (all-fours) position. Have the patient shift his or her body weight from one extremity to the other (rock back and forth). Apply resistance against the shoulders • Progress by having the patient alternately lift one extremity and then the other, so one extremity bears the body weight and stabilizes against the shifting load. • Apply manual resistance to the shoulders or strap a weight around each wrist. • When the muscles are able to control and stabilize, progress to using unstable surfaces [such as a rocker board, wooble board, or ball] • Dynamic Strengthening Exercises—Scapular Muscles • Scapular Retraction (Rho ...
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