Quickly review your physical exam skills, and make evidence informed clinical decisions. All while earning CME Credit.

Active Elevation Lag Sign (Trapezius)

The active elevation lag sign is used to detect trapezius muscle dysfunction or spinal accessory nerve palsy. To perform this test, ask the patient to forward flex her arm at the shoulder on the unaffected side. Next, ask her to forward flex her arm at the shoulder on the affected side. If there is no difference, or no lag, the test is normal. If there is an observable lag between the affected and unaffected arms, the test is positive. Alternatively, if the patient hyperextends her back to compensate for the lag, the test is positive.

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