APLEY'S SCRATCH TEST

​TEST POSITIONING

The client may sit or stand. The therapist stands next to the client.

ACTION #1

The client is instructed to take one hand and touch the opposite shoulder.

Repeat with the other hand to the opposite side.

POSITIVE FINDING #1

Asymmetrical results from side to side are positive.

The inability to touch the opposite shoulder is indicative of limited glenohumeral adduction, internal rotation, and horizontal flexion.

Limits in scapular protraction may also produce asymmetrical results.

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ACTION #2

The client is then instructed to place the arm overhead and reach behind the neck as if scratching the upper back.

Repeat with the opposite side.

POSITIVE FINDING #2

Asymmetrical results from side to side are positive.

Decreased motion on one side is indicative of limited glenohumeral abduction and external rotation, and scapular upward rotation and elevation.

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ACTION #3

The client is then instructed to place the hand in the small of the back and reach upward as far as possible.

Repeat with the opposite side.

POSITIVE FINDING #3

Asymmetrical results from side to side are positive.

Decreased motion on one side is indicative of limited glenohumeral adduction and internal rotation, and scapular retraction and downward rotation.

CONSIDERATIONS & COMMENTS

​Each of these movements is an active test of the functional mobility of the shoulder.

Care should be taken to isolate movements that are restricted.

It is not uncommon for a client to have slightly greater restriction on the dominant shoulder as compared to the nondominant shoulder due to increased muscle mass on the dominant side.

For the latter two test components, the therapist can correlate the thumb of the client with the level of the spinous process being reached for assessment comparisons over time.

The therapist should also assess scapular asymmetries that may be present with glenohumeral motion.