The supine apprehension test helps predict the risk of recurrent instability after a first-time anterior shoulder dislocation

Researches previously identified the positive result of the supine apprehension test after completion of rehabilitation following a first dislocation as a possible predictor of high risk for redislocation. They extend the follow-up of a previous cohort of patients with first-time shoulder dislocations to better assess this test. Fifty-three men, 17 to 27 years old, who suffered a first traumatic shoulder dislocation were treated by shoulder immobilization for 4 weeks and then rehabilitated with a standard physical therapy protocol. At 6-week follow-up, a supine anterior apprehension test was performed to assess the risk of redislocation. The patients were observed prospectively for at least 75 months. Of the 53 participants, 52 (mean age, 20.2 years) completed the study follow-up. Of the 52 subjects, 41 (79%) were combat soldiers. Follow-up was between 75 and 112 months. Of the 52 subjects, 31 (60%) redislocated at a range of 3 to 70 months after the initial dislocation. Eleven of 14 subjects (79%; confidence interval, 52%-92%) with a positive anterior apprehension test result redislocated, compared with 20 of 38 patients (53%; confidence interval, 37%-68%) with a negative test result. Patients with a positive test result redislocated more and earlier (P=.02, PROC LIFETEST, SAS).

The results of the supine apprehension test after a first shoulder dislocation and rehabilitation can assist in the prediction of risk for recurrent instability. It potentially may be included as a variable in decision analysis models.

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