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test-side arm shoulder at 90 degrees abduction and elbow in 90 degrees flexion
For grades 0-2 the patient is seated with arm externally rotated (palm up) and arm supported on a flat surface such as a plinth ('gravity minimal' position)
Stand at test side
Palpate shoulder adductor muscles
Patient to perform scapula adduction "lift tip of elbow towards the ceiling"
For grades 4 to 5, provide resistance over distal humerus in the direction opposite to scapular adduction 
Note:as with all resisted testing of vertebroscapular muscles, the preferred resistance point is that which constitutes the longest lever as this more closely reflects the functional demands of the limb.
To satisfy grade 5 'normal muscle' performance criteria, the patient must have the ability to move through complete range of motion (active resistance testing) OR maintain an end point range (break testing) against maximum resistance.
↑Hislop H, Avers D, Brown M. Daniels and Worthingham's muscle Testing-E-Book: Techniques of manual examination and performance testing. Elsevier Health Sciences; 2013 Sep 27.
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