Wright Test

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Purpose

Wright test or hyper abduction test is a provocative test  for Thoracic Outlet Syndrome  is thought to implicate the axillary interval (space posterior to pectoralis minor)

Technique

Starting Position

the test is performed in the sitting and then in a the supine positions

Procedure

the test is performed in 2steps

1. first step:

• head forward,while the arm is passively brought into abduction and external rotation to 90 without tilting the head.
• The elbow is flexed no more than 45. The arm is then held for 1 min
• the tester measure radial pulse and monitor patient symptoms onset

1. seconed step:

1. The tester monitors the patient’s symptom onset and the quality of the radial pulse.

• The test is repeated with extremity in hyperabduction (end range of abduction) .

Positive Test

A decrease in the radial pulse and/or reproduction of the patient’s symptoms

The pulse disappearance indicates a positive test result for thoracic outlet syndrome

Evidence

• Given the numerous possible causes and symptoms associated with TOS, no single test can unequivocally establish the presence or absence of the condition, particularly where sTOS is concerned (Roos, 1982; Lindgren, 1997).

• The classic provocation tests have been reported to be unreliable and frequently positive (up to 90%) for pulse obliteration in healthy patients (Hachulla et al., 1990; Urschel et al., 1994; Rayan and Jensen, 1995; Nannapaneni and Marks, 2003).