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Physical examination should include observation of upper extremity function with the patient sitting and, if appropriate, during activity or walking. Patterns of movement should be noted and the presence of movement disorders should be characterized (eg, athetosis, dystonia). Movement disorders are a relative contraindication to operative interventions on the upper extremity and can result in opposite deformities (eg, the “athetoid shift”). The examination should also include an assessment of sensibility, measurements of active and passive range of motion and an assessment of the degree of spasticity by the Ashworth Scale, the Modified Ashworth Scale or the Tardieu Scale.