Moving Patellar Apprehension Test: Difference between revisions

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'''Original Editor '''- David Adamson  
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== Purpose<br> ==
== Purpose ==


<br>This is a test that is designed for the clinical identification of lateral patellar instability.&nbsp;<ref name="stress">Ahmad CS, McCarthy M, Gomez JA, Shubin Stein BE. The moving patellar apprehension test for lateral patellar instability. Am J Sports Med. 2009 Apr;37(4):791-6. Epub 2009 Feb 3.</ref>  
This is a test that is designed for the clinical identification of lateral patellar instability.&nbsp;<ref name="stress">Ahmad CS, McCarthy M, Gomez JA, Shubin Stein BE. The moving patellar apprehension test for lateral patellar instability. Am J Sports Med. 2009 Apr;37(4):791-6. Epub 2009 Feb 3.</ref>  


== Technique<br> ==
== Technique ==


The moving patellar apprehension test is performed in two parts.&nbsp; Part 1 is a provocation oriented test.&nbsp; The examiner places the knee to be examined into full extension. A lateral force is applied to the patella with the examiners thumb.&nbsp; The examiner then moves the knee from full extension to 90 deg of flexion and then returning to full extension while maintaining the laterally applied force on the patella.&nbsp;&nbsp;  
The moving patellar apprehension test is performed in two parts.&nbsp; Part 1 is a provocation oriented test.&nbsp; The examiner places the knee to be examined into full extension.&nbsp; A lateral force is applied to the patella with the examiner's thumb.&nbsp; The examiner then moves the knee from full extension to 90 deg of flexion and then returning to full extension while maintaining the laterally applied force on the patella.&nbsp;&nbsp;  


The second aspect of the test (Part 2)&nbsp;consists of a symptom alleviation maneuver.&nbsp;&nbsp;The&nbsp;examiner repeats the part 1 of the test with a medially applied force on the patella.&nbsp;&nbsp;The examiner places the knee to be examined into full extension. A&nbsp;medial&nbsp;force is applied to the patella with the examiners index finger.&nbsp; The examiner then moves the knee from full extension to 90 deg of flexion and then returning to full extension while maintaining the medially&nbsp;applied force on the patella.&nbsp;&nbsp;  
The second aspect of the test (Part 2)&nbsp;consists of a symptom alleviation manoeuver.&nbsp;&nbsp;The&nbsp;examiner repeats the part 1 of the test with a medially applied force on the patella.&nbsp;&nbsp;The examiner places the knee to be examined into full extension. A&nbsp;medial&nbsp;force is applied to the patella with the examiner's index finger.&nbsp; The examiner then moves the knee from full extension to 90 deg of flexion and then returning to full extension while maintaining the medially&nbsp;applied force on the patella.&nbsp;&nbsp;  


A positive test consists of orally expressed apprehension or quadriceps recruitment on the provocation test (part 1),&nbsp;and alleviation of these symptoms with normal ROM&nbsp;within the test ROM&nbsp;in part 2 of the test.&nbsp;&nbsp;  
A positive test consists of orally expressed apprehension or an apprehensive quadriceps recruitment on the provocation test (part 1),&nbsp;and alleviation of these symptoms with normal ROM&nbsp;within the test ROM&nbsp;in part 2 of the test.&nbsp;&nbsp;  
 
{{#ev:youtube|4TJaS4IAUVk|300}}<ref>Clinically Relevant Technologies, http://www.youtube.com/watch?v=4TJaS4IAUVk ;accessed May 2011</ref>


== Evidence  ==
== Evidence  ==


The authors of the test compared the findings of the moving patellar apprehension test with the stability of the patella to laterally directed force under anesthesia.&nbsp;  
The authors of the test compared the findings of the moving patellar apprehension test with the stability of the patella to laterally directed force under anaesthesia.&nbsp;  


The test was found to have the following:  
The test was found to have the following:  
{| class="wikitable"
!Sensitivity:&nbsp; 100%
!Positive predictive value:&nbsp; 89.2%
|-
|Specificity: 88.4%
|Negative predictive value:&nbsp; 100%
|}


Sensitivity:&nbsp; 100%&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Positive predictive value:&nbsp; 89.2%
== Resources  ==


Specificity: 88.4%&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Negative predictive value:&nbsp; 100%
&nbsp; [http://www.ncbi.nlm.nih.gov/pubmed/19193601?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=9 Moving Patellar Apprehension Test]


<br>
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
<div class="researchbox">
'''<rss>Feed goes here!!|charset=UTF-8|short|max=10</rss>'''&nbsp; [http://www.ncbi.nlm.nih.gov/pubmed/19193601?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=9 Moving Patellar Apprehension Test]
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== References  ==
== References  ==
<references />


References will automatically be added here, see [[Adding References|adding references tutorial]].
[[Category:EIM_Residency_Project]]  
 
[[Category:Knee]]
<references />
[[Category:Assessment]]
 
[[Category:Special_Tests]]  
[[Category:EIM Student Project 2]]
[[Category:Musculoskeletal/Orthopaedics]]  
 
[[Category:Knee]]


[[Category:Assessment]]
[[Category:Knee - Assessment and Examination]]
[[Category:Primary Contact]]
[[Category:Sports Medicine]]
[[Category:Sports Injuries]]
[[Category:Athlete Assessment]]
[[Category:Knee - Special Tests]]

Latest revision as of 21:45, 31 January 2021

Original Editor - David Adamson

Top Contributors - David Adamson, Admin, Kim Jackson, Dan Rhon, Daniele Barilla, WikiSysop, Claire Knott and Wanda van Niekerk  

Purpose[edit | edit source]

This is a test that is designed for the clinical identification of lateral patellar instability. [1]

Technique[edit | edit source]

The moving patellar apprehension test is performed in two parts.  Part 1 is a provocation oriented test.  The examiner places the knee to be examined into full extension.  A lateral force is applied to the patella with the examiner's thumb.  The examiner then moves the knee from full extension to 90 deg of flexion and then returning to full extension while maintaining the laterally applied force on the patella.  

The second aspect of the test (Part 2) consists of a symptom alleviation manoeuver.  The examiner repeats the part 1 of the test with a medially applied force on the patella.  The examiner places the knee to be examined into full extension. A medial force is applied to the patella with the examiner's index finger.  The examiner then moves the knee from full extension to 90 deg of flexion and then returning to full extension while maintaining the medially applied force on the patella.  

A positive test consists of orally expressed apprehension or an apprehensive quadriceps recruitment on the provocation test (part 1), and alleviation of these symptoms with normal ROM within the test ROM in part 2 of the test.  

[2]

Evidence[edit | edit source]

The authors of the test compared the findings of the moving patellar apprehension test with the stability of the patella to laterally directed force under anaesthesia. 

The test was found to have the following:

Sensitivity:  100% Positive predictive value:  89.2%
Specificity: 88.4% Negative predictive value:  100%

Resources[edit | edit source]

  Moving Patellar Apprehension Test

References[edit | edit source]

  1. ↑ Ahmad CS, McCarthy M, Gomez JA, Shubin Stein BE. The moving patellar apprehension test for lateral patellar instability. Am J Sports Med. 2009 Apr;37(4):791-6. Epub 2009 Feb 3.
  2. ↑ Clinically Relevant Technologies, http://www.youtube.com/watch?v=4TJaS4IAUVk ;accessed May 2011
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