Upper limb tension test A

Original Editor - Jennifer Self

Top Contributors - Jennifer Self, Evan Thomas, Johnathan Fahrner and Claire Knott


  • To test for the presence of cervical radiculopathy
  • A component of the Test Item Cluster for the Diagnosis of Cervical Radiculopathy to determine the likelihood that a patient has cervical radiculopathy


The patient is supine. The examiner performs the following movement sequence:

  • Scapular depression
  • Shoulder abduction
  • Forearm supination, wrist and finger extension
  • Shoulder lateral elevation
  • Elbow extension
  • Contralateral/ipsilateral cervical side bending

Positive Test

The test is positive if one or more of the following occurs:

  • Symptoms reproduced
  • Side to side difference in elbow extension greater than 10 degrees
  • Contralateral cervical side bending increases symptoms, or ipsilateral side bending decreases symptoms



Diagnostic Accuracy[3]

Reference standard cervical radiculopathy as diagnosed by needle electromyography and nerve conduction studies.

Sensitivity= .50

Specificity= .86

-LR= .58

+LR= 3.5


Inter-examiner Kappa= .76


Neurodynamic Assessment


  1. Flynn TW, Cleland JA, Whitman JM. Users' Guide To The Musculoskeletal Examination. Evidence in Motion; 2008.
  2. ULTT Median Nerve Bias. (2009, June 8). ClinicallyRelevant.com: Upper Limb Tension Test A [Video]. Retrieved Nov 15, 2009, from http://www.youtube.com/watch?v=dlGVm4uKCMY
  3. Hartley A. Practical Joint Assessment. St Louis: Mosby; 1995.