What is the proper protocol for the drop arm test?

What is the proper protocol for the drop arm test?

• A. The patient actively abducts to 60 degrees and holds.
• B. The examiner resists abduction at 30 degrees while the patient stabilizes.
• C. The patient slowly lowers the arm from 90 degrees while the examiner observes.
• D. The examiner passively abducts the arm to 90 degrees and asks the patient to slowly lower it in a controlled manner.

Answer: (D)

The drop arm test checks rotator cuff integrity, especially the supraspinatus, by evaluating the ability to control a arm that's been placed in abduction against gravity. The proper protocol requires the examiner to passively lift the patient’s arm to 90 degrees of abduction (in the scapular plane) with the elbow extended, and then ask the patient to slowly lower the arm in a controlled manner. If the arm drops suddenly or cannot be lowered smoothly, it suggests a rotator cuff tear or significant weakness. This approach matters because passive positioning isolates the weakness of the rotator cuff from the patient’s own initiating effort, letting gravity and the intact structures test whether the cuff can maintain abduction. The other options either involve active abduction or lack the essential passive 90-degree positioning followed by controlled lowering, so they don’t test the same mechanism as the drop arm test.

The drop arm test checks rotator cuff integrity, especially the supraspinatus, by evaluating the ability to control a arm that's been placed in abduction against gravity. The proper protocol requires the examiner to passively lift the patient’s arm to 90 degrees of abduction (in the scapular plane) with the elbow extended, and then ask the patient to slowly lower the arm in a controlled manner. If the arm drops suddenly or cannot be lowered smoothly, it suggests a rotator cuff tear or significant weakness.

This approach matters because passive positioning isolates the weakness of the rotator cuff from the patient’s own initiating effort, letting gravity and the intact structures test whether the cuff can maintain abduction. The other options either involve active abduction or lack the essential passive 90-degree positioning followed by controlled lowering, so they don’t test the same mechanism as the drop arm test.