To test for the integrity of the thoracic outlet.
• The patient is seated.
• The examiner observes by standing in front.
• The patient is asked to abduct their arms to 900 and flex their elbows upwards also at 900 (the surrender position). The patient is then asked to repeatedly open and close their fists at modest speed for approximately 3 minutes. Expanding the thorax by taking in a large breath may aggravate the symptoms.
• Observe for signs of fatigue or a downward drift.
Positive if the patient shows early fatigue, numbness, tingling, heaviness or a sudden drop of the arms.
Signifies compromised thoracic outlet affecting the function of the brachial plexus and subclavian artery.