ULTT 26-03-2020.pptx

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1. UPPER LIMB TENSION TEST Dr Ankit Pachori P.G Dept. of physiotherapy

2. ULTT 1 METHOD The examiner faces the patient in stride standing, his right hand holding her left hand ensuring control rightdown to the thumb and finger tips. Her upper arm rests on me examiner's left thigh

3. The patient's arm is subsequently abducted in lhe coronal plane to approximately 110", Greater control and support of the arm can be achieved if the abduction component is performed with the patient's arm resting on the physiotherapist's thigh. In this way, the physiotherapist can walk the arm up into abduction whilst maintaining complete support and control o f the movement

4. With this position maintained, the forearm is supinated and the wrist and fingers extended. The shoulder is laterally rotated. The elbow is extended,Earlier component positions must be strictly maintained.

5. With this position held, cervical lateral flexion to the left and then to the right arc added. 'Keep looking at the ceiling and take your car to your shoulder' is a useful command.

6. The most important pan of the test, and indeed of any tension test, is that once pan o f the rest has been taken up. these positions must be firmly maintained before the addition of the next component. Symptoms and symptom changes must be identified and interpreted after each step.

7. All alternative method of handling In the second stage, rather than maintaining the shoulder girdle depression by the examiner's fist on the bed. the physiotherapist can place his left elbow on the patient's shoulder girdle with his forearm along her upper ann.

8. Precautions

9. Variation Bilateral ULTT1. ULTTI + BILATERAL SLR ULTT1 in diff positions of ABD(70,110,130,170) 110: optimal for C5,6,7

10. ULTT2

11. Using his thigh, the examiner carefully depresses the patient's shoulder girdle. Quite a sensitive feel can be developed with the thigh and the obvious advantage is that the depression can be maintained, leaving two hands free (or movement combinations of the rest of the arm. The test will have to be performed in approximately 10° of shoulder abduction so that the arm is clear and parallel to the side of me bed.

12. The shoulder depression is maintained and then the examiner subsequently extends the patient's elbow. The shoulder girdle depression/elbow extension position is maintained and the examiner, using both arms; laterally rotates the patient‘s whole arm

13. With this position maintained, the examiner's left forarm is pronated and slides down to the patient's hand. The examiner's thumb is slipped in the web space between the patient's thumb and index finger. The examiner then extends the patient's wrist, fingers and thumb. This position provides good control over the arm, including the tips of the fingers

14. The most common sensitising addition is abduction of the shoulder

15. ULTT 3 (ULNAR NERVE BIAS) Method The patient and the physiotherapist are in me same starring position as for ULTT. Note the stride standing position of the physiotherapist, such that the body can be used to make the test a smooth flowing action with minimal foot movements. The patient'S elbow is rested just below the anterior superior iliac spine, in the examiner's left groin

16. ELBOW FLEXION TEST: Cubital tunnel syndrome.