The brachial plexus provocation test.

The Brachial Plexus Provocation Test (BPPT) (or Upper Limb Tension Test) is used by clinicians to assess mechanical sensitivity of peripheral nerve tissue in the upper quadrant. The BPPT as developed by Elvey (1979) is performed in the following sequence: gentle shoulder depression, glenohumeral abduction to 90° and external rotation in the coronal plane, forearm supination and wrist and finger extension. Elbow extension to pain threshold is then performed manually by the clinician. The BPPT biases the median nerve, and variations using different movements may bias the ulnar or radial branches of the brachial plexus (Butler 1991)