What is Hyperabduction Test Or Wright Test? | Physiotherapy

Hyperabduction Test

Hyperabduction test

The Hyperabduction Test is a clinical sign in which the radial pulse weakens or disappears when the arm is captured and superficially rotated. It happens in some patients with thoracic outlet syndrome.

Purpose of hyperabduction test

The Wright test or hyperabduction test is a provocation test for the thoracic opening syndrome that is believed to include the axillary interval (space posterior to the pectoralis minor).

Initial position: the test is performed in the sitting and then in the supine positions

Process of hyperabduction test

The hyperabduction test is done in 2 steps

First step

Head forward, while the arm is passively abducted and externally rotated to 90 degrees without tilting the head.

The elbow is flexed no more than 45 degrees. The arm is then held for 1 minute. The tester measures the radial pulse and monitors the onset of the patient’s symptoms

Second step

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

The test is repeated with the limb in hyperabduction (final range of abduction).

Positive test

Decreased radial pulse and/or reproduction of the patient’s symptoms. The evaporation of the pulse indicates a positive test result for thoracic outlet syndrome.

Diagnostic accuracy

Patients with vascular types of thoracic outlet syndrome regularly describe their pain as fullness, heaviness, clumsiness, or weakness in the arm. The patient may also have subjective complaints of swelling, either enduring or recurrent.

When executing the hyperabduction test, the examiner places the enduring in a position that compresses the neurovascular bundle as it travels below the pectoralis minor muscle, resulting in a reduction in radial pulse strength. When performing the Wright test, it is important to also test the contralateral side to understand the patient’s normal radial pulse.

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