Costoclavicular or Military Brace or Eden’s Test: Difference between revisions

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== Purpose<br>  ==
== Purpose   ==


Test for presence of costoclavicular syndrome<br>  
Test for presence of [[Thoracic Outlet Syndrome (TOS)|thoracic outlet syndrome]].<br>  


== Technique<br>  ==
== Technique   ==


Patient is standing. The examiner palpates the radial pulse and then draws the patient's shoulder down and back as the patient lifts their chest in an exaggerated "at attention" posture. A positive test is indicated by an absence or decrease in vigor of the pulse and implies possible costoclavicular syndrome. This test is particularly effective in patients who complain of symptoms while wearing a backpack or heavycoat.<ref name="1">The Student Physical Therapist [Internet]  Available from: http://www.thestudentphysicaltherapist.com/costoclavicular-brace.html</ref><ref name="2">Magee DJ. Orthopaedic Physical Assessment. 4th ed. Canada: Elsevier; 2006</ref><ref name="3">NICHOLAS INSTITUTE OF SPORTS MEDICINE AND ATHLETIC TRAUMA [Internet]  Available from:  http://www.nismat.org/patients/injury-evaluation-treatment/head-neck-back/thoracic-outlet-syndrome-more-than-just-a-pain-in-the-neck</ref>  
Patient is standing. The examiner palpates the radial pulse and then draws the patient's shoulders down and back as the patient lifts their chest in an exaggerated "at attention" posture. A positive test is indicated by an absence or decrease in vigor of the pulse and implies possible costoclavicular syndrome. It is also positive if the client experiences an increase of neurologic symptoms into the upper extremity on that side. This test is particularly effective in patients who complain of symptoms while wearing a backpack or heavycoat.<ref name="p1">The Student Physical Therapist [Internet]  Available from: http://www.thestudentphysicaltherapist.com/costoclavicular-brace.html</ref><ref name="p2">Magee DJ. Orthopaedic Physical Assessment. 5th ed. Canada: Elsevier; 2006</ref><ref name="p3">NICHOLAS INSTITUTE OF SPORTS MEDICINE AND ATHLETIC TRAUMA [Internet]  Available from:  http://www.nismat.org/patients/injury-evaluation-treatment/head-neck-back/thoracic-outlet-syndrome-more-than-just-a-pain-in-the-neck</ref>  


<br>


{{#ev:youtube|ZPZlfxmT_Kk}}  
{{#ev:youtube|Mifo6ZzkNLA|300}}<ref>Physiotutors. Eden Test / Military Brace Test | Thoracic Outlet Syndrome (TOS). Available from: https://www.youtube.com/watch?v=Mifo6ZzkNLA [last accessed 16/2/2022]</ref>


== Importance of Test  ==
== Importance of Test  ==


Patients with Vascular types of costoclavicular syndrome often describe their pain as a fullness, heaviness, clumsiness, or weakness in their arm. The patient may also have subjective complaints of swelling, either permanent or intermittent. When performing the Costoclavicular Brace Test, the examiner is placing the patient in a position that compresses the neurovascular bundle between the first rib and clavicle, thus resulting in a decrease in pulse strength. When performing this test, it is important to test the contralateral side as well to understand the patient's normal radial pulse.<ref name="1" />  
Patients with vascular types of thoracic outlet syndrome often describe their pain as a fullness, heaviness, clumsiness, or weakness in their arm. The patient may also have subjective complaints of swelling, either permanent or intermittent. When performing the Costoclavicular Brace Test, the examiner is placing the patient in a position that compresses the neurovascular bundle between the first rib and clavicle, thus resulting in a decrease in pulse strength. When performing this test, it is important to test the contralateral side as well to understand the patient's normal radial pulse.<ref name="p1" />  


== References<br>  ==
== Evidence ==


<references />  
Demirbag et al<ref>Demirbag D, Unlu E, Ozdemir F, Genchellac H, Temizoz O, Ozdemir H, Demir MK. The relationship between magnetic resonance imaging findings and postural maneuver and physical examination tests in patients with thoracic outlet syndrome: results of a double-blind, controlled study. Arch Phys Med Rehabil. 2007 Jul;88(7):844-51.</ref> compared MRI findings to postural maneuver tests for thoracic outlet syndrome. They recommend the military brace test with moderate support for use in clinical diagnostics of thoracic outlet syndrome.
== References  ==


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[[Category:Shoulder]]
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[[Category:Shoulder - Special Tests]]
[[Category:Thoracic Spine]]
[[Category:Thoracic Spine - Special Tests]]

Latest revision as of 22:33, 16 February 2022

Original Editor - Venus Pagare

Top Contributors - Venus Pagare, Patti Cavaleri, Rachael Lowe, Kai A. Sigel, Admin, Tony Lowe, George Prudden, WikiSysop and Kim Jackson  

Purpose[edit | edit source]

Test for presence of thoracic outlet syndrome.

Technique[edit | edit source]

Patient is standing. The examiner palpates the radial pulse and then draws the patient's shoulders down and back as the patient lifts their chest in an exaggerated "at attention" posture. A positive test is indicated by an absence or decrease in vigor of the pulse and implies possible costoclavicular syndrome. It is also positive if the client experiences an increase of neurologic symptoms into the upper extremity on that side. This test is particularly effective in patients who complain of symptoms while wearing a backpack or heavycoat.[1][2][3]


[4]

Importance of Test[edit | edit source]

Patients with vascular types of thoracic outlet syndrome often describe their pain as a fullness, heaviness, clumsiness, or weakness in their arm. The patient may also have subjective complaints of swelling, either permanent or intermittent. When performing the Costoclavicular Brace Test, the examiner is placing the patient in a position that compresses the neurovascular bundle between the first rib and clavicle, thus resulting in a decrease in pulse strength. When performing this test, it is important to test the contralateral side as well to understand the patient's normal radial pulse.[1]

Evidence[edit | edit source]

Demirbag et al[5] compared MRI findings to postural maneuver tests for thoracic outlet syndrome. They recommend the military brace test with moderate support for use in clinical diagnostics of thoracic outlet syndrome.

References[edit | edit source]

  1. ↑ 1.0 1.1 The Student Physical Therapist [Internet] Available from: http://www.thestudentphysicaltherapist.com/costoclavicular-brace.html
  2. ↑ Magee DJ. Orthopaedic Physical Assessment. 5th ed. Canada: Elsevier; 2006
  3. ↑ NICHOLAS INSTITUTE OF SPORTS MEDICINE AND ATHLETIC TRAUMA [Internet] Available from: http://www.nismat.org/patients/injury-evaluation-treatment/head-neck-back/thoracic-outlet-syndrome-more-than-just-a-pain-in-the-neck
  4. ↑ Physiotutors. Eden Test / Military Brace Test | Thoracic Outlet Syndrome (TOS). Available from: https://www.youtube.com/watch?v=Mifo6ZzkNLA [last accessed 16/2/2022]
  5. ↑ Demirbag D, Unlu E, Ozdemir F, Genchellac H, Temizoz O, Ozdemir H, Demir MK. The relationship between magnetic resonance imaging findings and postural maneuver and physical examination tests in patients with thoracic outlet syndrome: results of a double-blind, controlled study. Arch Phys Med Rehabil. 2007 Jul;88(7):844-51.
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