Exploring the clinical utility of shoulder special tests included in National Physical Therapy Examination study materials: a critical review

Background: Many shoulder special tests lack diagnostic utility yet continue to be used in clinical practice. Identifying where these tests continue to be learned and taught is crucial to reducing their clinical use. Objectives: The purpose of this review was to summarize current content on shoulder special tests across National Physical Therapy Examination (NPTE) study materials and determine the extent to which NPTE study materials are consistent with current evidence on shoulder special tests. Major Findings: One hundred nineteen shoulder special tests were identified across the NPTE study resources. Fourteen tests were identified as the most frequently reported, 6 of which (42.8%), were deemed to have good clinical utility. Discrepancies in the naming, purpose, description, and interpretation of certain tests were also noted. Conclusions: Study materials for the NPTE contain content on shoulder special tests that lack clinical utility. This may be a contributing factor to ongoing clinical use of these tests. Educators, as well as students studying for the NPTE, should understand that a test’s inclusion or exclusion from NPTE study materials may not reflect its clinical utility. Removing shoulder special tests that lack clinical utility from NPTE study materials may help reduce their use in clinical practice.