Upper extremity functional testing

Connor Fedge, SPT

     Return to sporting activity is the final phase of the rehabilitation process for many athletes. It is an essential step to be sure that the patient can safely return to a
practice or game situations without putting him or herself at an increased risk for
injury. However, many authors agree that before beginning sport specific
movements certain criteria must be met. 
     It has been reported in the literature that a patient rehabilitating an upper
extremity injury should demonstrate the following prior to beginning return to
sport training; full functional range of motion, no pain or tenderness, strength 75-
80% to the non injured extremity and satisfactory shoulder stability. The Gleno-
Humeral joint is designed more for mobility than stability; therefore neuromuscular
control is required to create a stable joint. Neuromuscular control is difficult to
assess with a single measurement, therefore the each of the factors that impact
shoulder stability needs to be thoroughly assessed.
     Numerous studies have pointed out that there is a lack of a correlation from
certain measurements (strength, ROM, subjective reports, etc.) and the ability to
perform functional activity, emphasizing the importance of functional testing.
Functional testing is common in the lower extremity when attempting to return to
sporting activity, however there is a lack of evidence and tests that involve the
upper extremity.
     The following presentation explains and summarizes nine upper extremity
functional tests and discusses the strengths and weaknesses of each. More research
is needed to determine the ideal populations or outcomes in many of these tests, yet
despite the lack of statistical support they may still contribute to the assessment of
the upper extremity shoulder stability.

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