| 
             Anterior Instability Test  | 
              
              
                | 
            Other Names | 
                
				Leffert’s 
				Test | 
              
              
                | 
            
            Examination type | 
                
				Joint 
				stability | 
              
              
                | 
            
            Patient & Body Segment Positioning | 
                
				The patient 
				will need to be seated and relaxed during the test. | 
              
              
                | 
            Examiner Position | 
                
				During the 
				test the examiner will be standing behind the shoulder of the 
				patient to be tested.  The examiner will place one hand over the 
				shoulder so that the index finger is over the anterior humeral 
				head and middle finger is over the coracoid with the thumb over 
				the posterior humeral head. The examiner will use the other hand 
				to grasp the patient's wrist. | 
              
              
                | 
            Performing the Test | 
                
				The examiner 
				will use the hand to grasping the patient’s wrist to abduct and 
				externally rotate the involved shoulder.  The examiner should 
				use the other hand to palpate for any translation of the humeral 
				throughout the test.  Observe the fingers resting on the humeral 
				head for movement forward during the test and for return to 
				starting position after the test as the humeral head slides back 
				into place. | 
              
              
                | 
            Tissues 
            Being Tested | 
                
				Glenohumeral 
				joint ligaments, anterior deltoid and rotator cuff muscles | 
              
              
                | 
            
            Positive Test | 
                
				Observing or 
				palpating the humeral head moving forward and returning to the 
				starting position. | 
              
              
                | 
            
            Interpretation | 
                
				Anterior 
				shoulder instability | 
              
              
                | 
            
            Common errors in 
            performing exam | 
                
				Improper 
				patient positioning, examiner positioning, or hand placement are 
				common errors. Also, improper movement of the shoulder during 
				the test is a common error. | 
              
              
                | 
            
            Factors possibly 
            resulting in misinterpretation | 
                
				Pre-existing 
				joint hyper-mobility | 
              
              
                | 
        Related tests | 
                
				Anterior 
				Translation Test, Relocation Test, Apprehension Test, Rockwood, 
				Prone anterior instability. | 
              
              
                | 
            
            References | 
                
				Magee, David 
				J. (2002). Orthopedic Physical Assessment. Philadelphia, 
				PA: Elsevier | 
              
              
                | 
            
            Links: | 
                
             
			
			
			http://www.wheelessonline.com/ortho/physical_exam_for_anterior_instability 
			
			
			
			http://www.fpnotebook.com/ORT121.htm  | 
              
              
                
                
                  
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