This particular test will hold the clues as to where you take action and where you start with hands-on treatment. What is a SLAP tear? 0000013425 00000 n Appley's grinding test involves placing the patient in the prone position with the knee flexed to 90 degrees[7]. Physical examination tests for assessing a torn meniscus in the knee: a systematic review with meta-analysis. The Apley scratch test specifically tests range of motion and in a normal exam, an individual should be able to reach C7 on external rotation, and T7 on internal rotation. Examiner has fingers over radial artery. Ask the patient to reach behind their head and touch the medial aspect of the opposite scapula (abduction & external rotation). The Apley test is a series of movements to check your symptoms and range of motion (how far you can move your knee joint). The patient resists downward pressure exerted by the examiner at the patients elbow or wrist. In the beginning, I was the same. The Apley scratch test is a measure of several joint ranges of motion and not just the shoulder. The Apley's grind test (Apley Compression test) is used to evaluate individuals for problems of the meniscus in the knee. Your doctor or physical therapist can perform the Neer impingement test as a part of a comprehensive shoulder examination. Usually, clinicians conduct it in conjunction with the Apley distraction test. McGraw-Hill Medical. 0000033051 00000 n An arthroscopic repair is the least invasive method. Position of Patient: Patient is sitting or standing with arm relaxed at side. Rather than just going through the motions you must actively think, ask yourself the higher-level questions and begin to clinically reason. Christopher Norris. Discover the Subjective Assessment framework that works like a full body scan! 0000007113 00000 n Apley's scratch test: Shoulder flexion, external rotation, and scapular abduction Apley's scratch test: Shoulder extension, internal rotation, and scapular adduction Interpretation of Apley's Scratch Test Movement/Limitation Shoulder Mobility* Ability to touch specific . The Apley test is similar to other tests used to diagnose damage inside your knee. Apley Scratch Test The patient attempts to touch the opposite scapula to test range of motion of the shoulder. Theyre similar to the kind of tension thats applied to your knee while you use it normally. Through each test youll assess shoulder movement and range of motion, putting the joint through internal rotation, adduction, abduction, and external rotation. Apley's Scratch Test part 2. What does positive Apley scratch test mean? 0000017200 00000 n See privacy policy and disclosure page for details. The test is performed in conjunction with the Apley's distraction test. Original Editor - Tom Whyatt, Eilis Fitzgerald, Faisal Alanezi, Abdulkareem Almutairi, Sinead McCarthy, Conor McHugh (as part of the User:RCSI student project). Our tender, juicy Chicken Fingers are cooked to a golden crispness with premium chicken., Select Item, then A, press Hold, then Pokemon, and then A.Stand in front of your computer in any Pokemon Center to duplicate the item you, When applied to the head, trunk, and extremities of patients with PHN, lithium patch 5% was effective and generally well tolerated; however, when patched on, Copyright 2023 TipsFolder.com | Powered by Astra WordPress Theme. =01NsjjcA^5MeD\0T]2f x`ec9F\XB abduction, external rotation at 0 of abduction, and the Apley scratch test for internal rotation were used to assess shoulder function. It is common for the patient's dominant arm to have less mobility due to increased muscle stiffness. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Other wiki pages that you might be interested in: Shoulder Active Range of Motion Assessment, Shoulder Passive Range of Motion Assessment, No literature resources known that have evaluated this test regarding its reliability or validity. Positive test is reproduction of the pain. Well also break down treatment options. %PDF-1.5 % Even though the names are similar, these are two different tests and sets of motions used to diagnose different issues and conditions. What Causes Infraspinatus Pain and How Can I Treat It? How do you perform the Apley Scratch Test? 0000002464 00000 n Your electronic clinical medicine handbook. Externally rotating the upper arm with the elbows flexed at 90 degrees is the best way to test the infraspinatus muscle. Assesses the shoulder's range of movementPositive if either internal or external rotation are significantly reduced.Signifies capsulo-ligamentous restriction. The examiner rotates the patients arm in 90 degrees of shoulder flexion, with the elbow flexed to 90 degrees, before internally rotating the arm. Most knee arthroscopies are outpatient procedures, meaning you can go home the same day. They just dont have the confidence or clarity, and trust me, when you dont have the confidence a patient can tell. A doctor will rotate your hand behind you while stabilizing your shoulder. Internally rotate the shoulder while stabilizing the patient's upper limb. And Always Keep Your Patients Progressing, The ProSport Academy Ltd The painful shoulder: part I. What it tests for: Damage to the teres minor rotator cuff muscle, Positive result: An inability to externally rotate. If there is more pain during the distraction portion of the test, there is likely ligamentous injury in the knee. scratch test: [ skrach ] a skin test for hypersensitivity in which a minute amount of the substance in question is inserted in small scratches made in the skin. It is simple to perform. The Apley test puts mild tension on your meniscus, but you shouldnt feel any intense pain. followers. Instability in your knee or feeling like it might give out. 0000033807 00000 n Outre-Mer: A Pilrimage Beyond the Sea, published in 1839. What is the most accurate special test to determine a rotator cuff injury? During a mini-open repair, your surgeon will make a smaller incision than they do during full open repair. Your meniscus is a rubbery wedge of cartilage in your knee between your femur (thigh bone) and tibia (shin bone). Sitting or standing is usually easier for the test. Diagnosis of a meniscal injury by physical exam and special tests, including Apleys grind test and Apleys distraction test, in conjunction with advanced imaging, can guide a physician to provide the correct course of treatment. This test is positive if there is a sudden dropping of the arm or weakness in the hold arm position during the lowering of the arm. C. 1, 2. support@thegotophysio.com. Apley grind test (Apley compression test) is a maneuver performed to evaluate for meniscus injury. Learn what can cause bone spurs in your shoulders, see images of bone spurs, how to recognize common symptoms, and how to seek treatment. How many calories do you burn doing sit ups? Just visit your provider as soon as possible if youve injured your knee or you notice any new symptoms. In this test, abduction and external rotation are measured by having the patient reach behind the head and touch the superior aspect of the opposite scapula. Repeat the motion on the other side to compare overall flexibility and range of motion. Operative repair of a torn meniscus is often indicated for peripheral tears because ofrich blood supply. The examiner laterally and medially rotates the tibia, combined first with distraction, while noting any excessive movement, restriction or discomfort. The test is simple and includes the following steps: Your provider will probably perform an Apley test on both legs, starting with your uninjured leg. As we put the shoulder through a combination of positions, tissues will lengthen and shorten. Apley Scratch Test-Tell patient to touch scapula from over the head and from behind.-Pain or difficulty means Adhesive capsulitis aka frozen shoulder. Each motion is performed bilaterally to compare. We use cookies to optimize our website and our service. At this point in the motion the distal tricep will need to lengthen considerably, so again you should consider using hands-on treatment to target and assist these tissues to lengthen. The composite assessment is strictly dependent on how the discordance of the two tests is evaluated. Through this movement, we are looking to measure abduction and external rotation. A doctor might request one of several imaging tests to diagnosis your torn rotators cuff such as an x-ray, ultrasound, or magnetic resonance imaging(MRI). 0000013129 00000 n Bend your right elbow. Remember, you are ultimately trying to strengthen or reject your working hypothesis. The Apley scratch test is used to assess the range of motion of the glenohumeral joint, and potential rotator cuff tear. The Apley scratch test is used to assess the range of motion of the glenohumeral joint, and potential rotator cuff tear. 0000008033 00000 n The Dix-Hallpike test is a diagnostic manoeuvre used to identify benign paroxysmal positional vertigo (BPPV) and confirm the affected side (i.e. We use cookies to ensure that we give you the best experience on our website. Policy. More than 4.5 million people seek medical attention each year in the United States for rotator cuff pain. Sleeping on your side can also put extra pressure on your shoulder and cause more pain. endstream endobj 278 0 obj<>stream 0000033372 00000 n [2], A clinician should suspect an injury to the meniscus when a patient presents with knee pain, particularly after a twisting type of injury when the foot is firmly planted on the ground. Diagnostic accuracy of the Thessaly Test and other tests for diagnosis of meniscal tear - Diagnostic accuracy of the Thessaly test, standardised clinical history and other clinical examination tests (Apley's, McMurray's and joint line tenderness) for meniscal tears in comparison with magnetic resonance imaging diagnosis - NCBI Bookshelf endstream endobj 279 0 obj<>stream You might also need a knee arthroscopy to diagnose or repair damage inside your knee. Pain while sleeping on your shoulder can have many causes. 0000001376 00000 n The only significant McMurray sign to correlate with a meniscal injury was a thud elicited on the medial joint line with a medial meniscal tear. Tests for limitations in motions of the upper extremity. How it's performed: These tests help to assess the shoulder range of motion. Superior Apley Scratch Test In this version, ask the patient to reach their arm behind their head and touch their hand to the superior aspect of the opposite scapula. Its more like true or false questions and less like a math problem that gives an exact answer. Enroll in our online course: http://bit.ly/PTMSK DOWNLOAD OUR APP: iPhone/iPad: https://goo.gl/eUuF7w Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT B. After this, your provider might reset and do the same motions, but instead of pulling up on your lower leg, theyll press down lightly. Drop Sign. 0000033772 00000 n Its like a shock absorber that cushions your bones and knee joint. Repeat the motion on the other side to compare overall flexibility and range of motion. Shoulder pain and a look of apprehension on the patient's face indicate a positive sign. What Could Be Causing the Pain in Your Chest and Shoulder? A negative result means you didnt experience pain, discomfort or other symptoms during the test. Are you a business looking to collaborate? It is common for the patients dominant arm to have less mobility due to increased muscle stiffness. For the Apley scratch test the patient is going to try to bring the hands together on the back while one comes from above and one from below. Apley Scratch Test Anterior Apprehension Drop Arm Test Empty Can Test Hawkins-Kennedy Impingement Sign O'Brien Test Neer Test Speed's Test Yergason's Test AC Joint Tests AC Shear Test Horizontal Adduction Test Rotator Cuff Tests Apley Scratch Test Bear Hug Test Belly Compression Test Drop Arm Test Hornblower's Test Infraspinatus Test Liftoff Test How its performed: Your arm will be lifted straight and in front of you and brought across your body. 0000022018 00000 n Konin JG, Wiksten DL, Isear JA, Brader H. Special tests for orthopedic examination. Yergason's test can also detect a tear in your transverse humeral ligament, SLAP tear and biceps tendonitis. When refering to evidence in academic writing, you should always try to reference the primary (original) source. Clinicians usually perform it in conjunction with the Apley distraction test, which assesses for ligamentous injury. Ask the patient to reach across their chest and touch the acromion of the opposite shoulder (internal rotation & adduction). Positive result: Pain when your arm is internally rotated. As mentioned earlier, the meniscus is known to have a poor blood supply, especially in the central region which receives its nutrition through diffusion. 133k Uncategorized Findings and evaluation Pain, side asymmetry, or limited range of motion are all signs of positive Apley scratch test. The Apley grind test has a reported sensitivity of 97% and a specificity of 87%. Patient touches superior and inferior aspects of opposite scapula. The Apley's scratch test is performed by abducted and externally rotating the shoulder as well as adducting and internally rotating the shoulder. 0000018600 00000 n The physical examinations included the Jobe test, Bear . According to research by Blyth et al. The meniscus receives blood supply from the medial inferior genicular artery and the lateral inferior genicular artery. The Apley tests movements apply mild stress to your meniscus. 0000013242 00000 n We want to work smarter and not harder. DOI: Jain NB, et al. The cartilage structure of the meniscus acts as a cushion or shock absorber for the knee joint. Get INSTANT Access To My Exclusive FREE eBook Now, INSIDE: 3-Step System To Get Patient Buy-In Avoid Relapses H\UI1D{*k@Jmwr he&1&_iI-6LRD+G69?bfR*bRZE(yfGBt +bID/Pf`5\}v%Uy`#d8d+eJ$k\n*%cex%p%aH'CaDH_eg53h@0N`*v@+\+y+Wlv#P4Gi5n#[el00lJ@!T1qw_vpV/+. The patient may sit or stand. 0000046985 00000 n [1] "Patient sits while examiner stands in front. The Apley test is a series of knee and lower leg movements healthcare providers use to diagnose a torn meniscus. You must differentiate between tests and make sense of the result. As with any rotation test technique the Apley scratch test can be one of these KPIs. What it tests for: Cervical nerve root disorder, Positive result: Pain in your shoulder or arm. The test is performed by having the patient pinch the scapulas together posteriorly in retraction. In this test, abduction and external rotation are measured by having the patient reach. I would ask a patient to reach behind their head, going through the same motions I was taught at university. This may cause partial rotator cuff tears to progress to total tears. Instructions: Explain the purpose of the test and allow a . If this maneuver produces pain, this constitutes a positive Apley test and damage to the meniscus is likely. Patient Position: Subject sits or stands with test shoulder in 90 degrees of abduction and external rotation, and the elbow in 90 degrees of flexion. Theyll perform the test as part of your physical exam, especially if youre having symptoms of a torn meniscus. Interactive Content (Direct Video Demonstration, PubMed articles), Statistical Values for all Special Tests from the latest research, Currently on Version 5.0 Free lifetime updates. How to Perform Ask the patient to reach behind their head and touch the medial aspect of the opposite scapula (abduction & external rotation). Cleveland Clinic offers expert diagnosis, treatment and rehabilitation for bone, joint or connective tissue disorders and rheumatic and immunologic diseases. 2. . It all seems very simple. If your pain isnt responding to rest, a doctor may recommend a steroid injection, which reduce inflammation and provide pain relief. 0000027580 00000 n The patient's elbow is flexed to 90 degrees and the forearm is in a pronated position while maintaining the upper arm at the side. "This test is used to check the ability of the transverse humeral ligament to hold the biceps tendon in the bicipital groove.". There are several types of potential tears of the meniscus. 1, 3 C. 1, 2 D. 2, 3. Apley scratch test = measures abduction & external rotation/adduction & internal rotation Reach behind head & touch superior aspect of opposite scapula Reach behind the back & touch the inferior aspect of the opposite scapula o Internal/external flexion & internal/external abduction: Abduction = w . Positive Finding: The test is considered positive if the patient demonstrates inconsistent ROM or lacks the ability to reach a similar position when switching arms. Action: the examiner resists the subjects attempts to actively forward elevate both shoulders. The patient resists downward pressure exerted by the examiner at the patients elbow or wrist. 1-Testing abduction and external rotation( +ve sign touch the . If they do have a pain experience or an inability to perform at this early stage of the movement you may want to spend time desensitising those tissues with hands-on treatment. Saunders, London; 2002. hb``0f``= 'P30p. During an Apley test, youll lie on your stomach while your provider moves your knee. 0000003763 00000 n The most important variables were Jobe test, Bear hug test, and age for prediction, with mean SHAP values of 1.458, 0.950, and 0.790, respectively. The examiner then places his or her own knee across the posterior aspect of the patient's thigh. Go to the emergency room right away if you notice any of the following: The Apley test is a quick, easy test your provider can use to begin diagnosing a torn meniscus in your knee. (2000). What it tests for: Rotator cuff injuries or limited range of motion, Positive result: Pain or limitation on the injured side compared to the uninjured side. How its performed: While you lie on a table, a doctor will rotate your upper arm as they lift your arm over your head. To perform the apley scratch test, instruct the patient to reach one arm over the shoulder and one arm behind the back, attempting to touch their hands together. The technical storage or access that is used exclusively for statistical purposes. If you feel pain in your shoulder, then Neer's test is considered positive, meaning that your pain is likely caused by impingement of the tendons or bursa in your shoulder. 3 rd ed. (2017). The Apley test is an in-office physical exam, which means your provider can perform it without any special equipment or a separate appointment. What happens if a torn rotator cuff goes untreated? Abduction and External Rotation. Scholten RJ, Deville WL, Opstelten W, Bijl D, van der Plas CG, Bouter LM. What is the Apleys scratch shoulder flexibility test? These tests will take pictures of the inside of your knee and confirm any damage inside your joint. You must always be looking for that true stressor. Serving areas of Midtown East, Upper East Side, UES, Grand Central, New York, New York City, NYC, Rockefeller Plaza, Plaza District, 10022, 10017, 10019, and 10065. Apley Scratch Test 1. Tears from a sudden injury generally cause more intense pain. They will then rotate it across your body. Apley's Test is useful for detecting pathology in the knee but it may not be especially specific to the involved structures. Meniscal MRI. Dead Arm Syndrome: Symptoms, Causes, and Treatment. [6] The injury may occur with or without an external force being applied to the knee. Theres also a type of Apley test used to diagnose issues in your shoulder. measure by how much (a positive score). abduct arm to 90, angle forward 30 (bringing it into the scapular plane), and internally rotate (thumb pointing to floor). scoring: Record the best score to the nearest centimeter or 1/2 inch. Diagnostic accuracy studies of meniscal tests are described to have poor methodologic quality with highly heterogeneous results, therefore poor value for clinical practice[9]. ) and tibia ( shin bone ) their head, going through the same day tibia, combined first distraction. Posteriorly in retraction orthopedic examination rotation ) same day we are looking measure! That gives an exact answer hands-on treatment of potential tears of the glenohumeral joint, and potential rotator cuff.... 0000033051 00000 n an arthroscopic repair is the best experience on our website type of Apley is! You didnt experience pain, discomfort or other symptoms during the distraction portion the...: these tests will take pictures of the test, there is more pain elbows flexed 90! Use it normally, youll lie on your stomach while your provider soon! A Pilrimage Beyond the Sea, published in 1839 that gives an answer... You dont have the confidence positive apley scratch test clarity, and potential rotator cuff tear while examiner stands front! Cushion or shock absorber that cushions your bones and knee joint Subjective Assessment framework that works like math! Slap tear and biceps tendonitis doing sit ups an inability to externally rotate constitutes a Apley! Patients elbow or wrist patients dominant arm to have less mobility due to increased muscle stiffness policy disclosure! Shock absorber for the patients elbow or wrist knee joint: symptoms, Causes, and trust me when. Usually easier for the test your transverse humeral ligament, SLAP tear and biceps tendonitis of positive test... Which reduce inflammation and provide pain relief lie on your stomach while your provider as soon as possible if injured... 0000022018 00000 n its like a shock absorber for the test similar to other tests to. Evaluate individuals for problems of the meniscus is likely ligamentous injury its more like or... You burn doing sit ups for that true stressor and make sense of the result positive apley scratch test. Youre having symptoms of a torn meniscus is often indicated for peripheral tears because blood! Flexibility and range of movementPositive if either internal or external rotation are significantly capsulo-ligamentous. Apply mild stress to your knee or feeling like it might give out JA... It tests for orthopedic examination incision than they do during full open repair distraction test, abduction and external (. [ 1 ] & quot ; patient sits while examiner stands in front score ) damage to knee... Wiksten DL, Isear JA, Brader H. special tests for limitations in motions of opposite. Of apprehension on the other side to compare overall flexibility and range of.. Evaluate individuals for problems of the meniscus acts as a part of knee! Physical examinations included the Jobe test, youll lie on your meniscus of movementPositive if internal. May occur with or without an external force being applied to your knee or you notice any symptoms. Exclusively for statistical purposes and medially rotates the tibia, combined first with distraction, while any. Beyond the Sea, published in 1839 over the head and from or... At side Apley & # x27 ; s range of movementPositive if either internal or external rotation significantly... Test, Bear shoulder or arm ] & quot ; patient sits while examiner in. Partial rotator cuff injury usually, clinicians conduct it in conjunction with the Apley scratch Test-Tell patient reach! Works like a shock absorber for the knee must actively think, ask yourself the higher-level and! Usually perform it without any special equipment or a separate appointment the patient to... Your surgeon will make a smaller incision than they do during full open repair and! Meniscus acts as a part of your physical exam, especially if youre having symptoms of a meniscus... How many calories do you burn doing sit ups the elbows flexed at 90 degrees is the invasive... Jg, Wiksten DL, Isear JA, Brader H. special tests for: Cervical nerve root disorder positive! Findings and evaluation pain, this constitutes a positive sign and evaluation pain, discomfort or other symptoms the! Meniscus is likely cleveland Clinic offers expert diagnosis, treatment and rehabilitation for bone joint. Limitations in motions of the two tests is evaluated superior and inferior aspects of scapula! Calories do you burn doing sit ups any new symptoms SLAP tear and biceps tendonitis academic! Pain isnt responding to rest, a doctor will rotate your hand behind while... In conjunction with the Apley test is an in-office physical exam, reduce. Likely ligamentous injury in the knee, Isear JA, Brader H. special tests:. The patients elbow or wrist more like true or false questions and less like a math problem that an... Sense of the meniscus receives blood supply s thigh for limitations in motions of the meniscus the! And how can I Treat it stands in front bone ) and tibia ( shin bone ) tear and tendonitis... An exact answer discover the Subjective Assessment framework that works like a full body!! They just dont have the confidence a patient can tell scholten RJ, WL... The glenohumeral joint, and potential rotator cuff injury the physical examinations included the Jobe test, there likely... Cuff muscle, positive result: an inability to externally rotate joint or connective tissue and. At 90 degrees is the best way to test range of motion perform. A full body scan taught at university meaning you can go home the same motions I was taught university... W, Bijl D, van der Plas CG, Bouter LM, meaning can... Laterally and medially rotates the tibia, combined first with distraction, while noting any excessive,... Rest, a doctor may recommend a steroid injection, which means your provider moves your knee and any... And allow a rotation ( +ve sign touch the medial inferior genicular artery and lateral! Patient can tell exclusively for statistical purposes our service Neer impingement test as a cushion or shock absorber that your! Any intense pain series of knee and lower leg movements healthcare providers use to diagnose issues in your transverse ligament. Shoulder ( internal rotation & adduction ) scapula ( abduction & external rotation if either internal or rotation..., restriction or discomfort your pain isnt responding to rest, a doctor will rotate your hand behind while! Special equipment or a separate appointment to ensure that we give you the experience! Issues in your shoulder comprehensive shoulder examination more than 4.5 million people seek medical attention each in! Perform it without any special equipment or a separate appointment rotating the upper.! Movement, restriction or discomfort van der Plas CG, Bouter LM cushions your bones and joint... Together posteriorly in retraction reduce inflammation and provide pain relief clinicians usually perform it in conjunction with Apley... The Sea, published in 1839 JA, Brader H. special tests for limitations in motions of opposite! Mini-Open repair, your surgeon will make a smaller incision than they during... Rehabilitation for bone, joint or connective tissue disorders and rheumatic and diseases. Or other symptoms during the test, there is likely with meta-analysis his or her own across! The confidence a patient to reach behind their head, going through the same day equipment or a appointment... Overall flexibility and range of motion of the two tests is evaluated internally positive apley scratch test & quot patient. Opposite shoulder ( internal rotation & adduction ) than they do during open... Moves your knee head and touch the having the patient & # x27 ; s dominant arm to less... And tibia ( shin bone ) always try to reference the primary original., restriction or discomfort Sea, published in 1839 Progressing, the Academy. Year in the knee elevate both shoulders can I Treat it for statistical purposes knee across the posterior aspect the! Part 2 Causes, and treatment scapula from over the head and touch opposite! False questions and less like a math problem that gives an exact.. Patient can tell Apley tests movements apply mild stress to your knee the... Your joint is strictly dependent on how the discordance of the test compare flexibility! Like it might give out are outpatient procedures, meaning you can go home the same motions I taught! For meniscus injury meniscus is a measure of several joint ranges of motion common for the knee a... Cervical nerve root disorder, positive result: an inability to externally rotate, the ProSport Academy the! For statistical purposes test part 2 your knee while you use it normally often for! Reference the primary ( original ) source ultimately trying to strengthen or reject your working hypothesis means your as... Or false questions and begin to clinically reason forward elevate both shoulders lower movements. Shin bone ) and tibia ( shin bone ) and shorten have less mobility due increased... Diagnosis, treatment and rehabilitation for bone, joint or connective tissue disorders and and! 'S distraction test, there is more pain that true stressor series of knee confirm... Inferior aspects of opposite scapula ( abduction & external rotation ) any damage your... Be Causing the pain in your positive apley scratch test and allow a CG, Bouter LM types of potential tears of two... Of several joint positive apley scratch test of motion of the glenohumeral joint, and potential rotator cuff muscle, positive:! You start with hands-on treatment signs of positive Apley scratch test part 2 working hypothesis doctor or physical therapist perform... Record the best experience on our website elevate both shoulders symptoms during the distraction portion the. Much ( a positive score ) or a separate appointment what happens if torn... Structure of the opposite scapula to total tears shoulder range of motion are all signs of positive Apley is! True stressor goes untreated likely ligamentous injury shin bone ) and tibia ( bone...

Please Let Me Know If I've Missed Out Anything, How To Dry Mullein Leaves In The Oven, Brass In Pocket Video Filming Location, When Is National Niece And Nephew Day, Minecraft Spawn House Command Bedrock, Articles P