Upper Limb Rotation Test: Validity and Reliability | Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews

Upper Limb Rotation Test: Validity and Reliability

Upper Limb Rotation Test: Validity and Reliability

Several risk factors exist for throwing-related shoulder injuries, such as:

  • Glenohumeral Internal Rotation Deficit (GIRD).
  • Reduced total range of motion.
  • Scapular dyskinesia.
  • External/internal rotation strength ratio imbalances.

Physical performance tests (PPTs) provide a a functional status of the athlete’s upper extremity.
These PPTs are routinely used for:

  • Injury prediction.
  • Performance enhancement.
  • Post-rehabilitation outcome measures.

Some PPTs have been developed for closed kinetic chain (CKC), such as:
Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST). -
and -
Open kinetic chain (OKC), such as:
Seated medicine ball throw (SMBT).
Many PPTs currently used do not fully address specific requirements of overhead throwing, including:
A combination of OKC, CKC and a trunk rotation as well as 90°/90° shoulder position .
To comply with this need, the Upper Limb Rotation Test (ULRT), may be better, as it includes:

  • Weight bearing.
  • Shoulder motor control and stability.
  • Involves the entire kinetic chain.
  • Places the shoulder in 90°/90° position.

Decleve et al. (2020) test 91 healthy adults to determine the reliability of the ULRT and examined the correlations with two widely used PPTs:
and .
2 clinical measurements:
Shoulder isometric rotational strength.
Trunk rotational range of motion (SRT).
High relative reliability values and clinically acceptable absolute reliability values were found.

The ULRT showed moderate correlations with the CKCUEST and SMBT.

The ULRT is a good physical performance test of:

  • OKC
  • CKC
  • Trunk rotation
  • 90°/90° shoulder position.


  • Very high intra-session reliability.
  • High reliability for test-retest.
  • Clinically acceptable absolute reliability.

Moderately correlated with:
Poorly correlated with:
Shoulder isometric rotational strength and SRT. .
Thoughts? Questions? Comments?
Write them below. .
Decleve et al. 2020. The “upper limb rotation test”: Reliability and validity. There in Sport.

Dalton Urrutia, MSc PT

Dalton is a Physical Therapist from Oregon, currently living and running the performance physiotherapy clinic he founded in London for Grapplers and Strength & Conditioning athletes. Dalton runs the popular instagram account @physicaltherapyresearch, where he posts easy summaries of current and relevant research on health, fitness, and rehab topics. 
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