Drop Arm Test
Original Editor - Beth Reuschel
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Purpose[edit | edit source]
The drop arm test is used to assess for full thickness rotator cuff tears, particularly of the supraspinatus[1]. This can be useful when diagnosing sub-acromial pain syndrome (shoulder impingment) or to differentiate between shoulder and rotator cuff pathologies.
The drop arm test may be more accurate when used in a battery of tests such as:
Performing a battery of tests will help to differentiate between rotator cuff muscles and give more accurate diagnosis[1].
Technique[edit | edit source]
- Stand behind the seated patient and passively abduct the patient's arm to 900 and full external rotation, while supporting the arm at the elbow
- Release the elbow support and ask patient to slowly lower the arm back to neutral.[2]
Instructional video[edit | edit source]
Interpretation[edit | edit source]
The test is negative if the patient is able to control the lowering of the arm slowly and without their symptoms occurring.
It is a positive test if there is a sudden dropping of the arm or weakness in maintaining arm position during the eccentric part of abduction, there may also be pain present while lowering the arm, suggesting a full thickness tear to the supraspinatus[4].
Sensitivity / Specificity[edit | edit source]
Sensitivity of detecting a full thickness supraspinatus tear: 73%[5] and a Specificity of: 77%[5]
Likelihood Ratio: 6.45 (95% CI=2.25–18.47)[6]
Evidence[edit | edit source]
It was found it is unclear if a full thickness rotator cuff tear can be diagnosed by using any of the cluster of lag signs, let alone solely the drop arm sign[5].
All lag sign tests for rotator cuff integrity have been shown to have high specificity but low sensitivity[6].
It is recommended to use a cluster of tests in order to assess the full capacity of the rotator cuff which will lessen waiting times and costs for radiographic imaging such as US or MRI.[7]
References[edit | edit source]
- ↑ 1.0 1.1 Sgroi M, Loitsch T, Reichel H, Kappe T. Diagnostic value of clinical tests for supraspinatus tendon tears. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2018 Aug 1;34(8):2326-33.
- ↑ Klaus Buckup. Clinical Tests for the Musculoskeletal System: Examinations - Signs - Phenomena. 2nd ed. Germany: Thieme, 2008
- ↑ Physiotutors. Drop Arm Test/sign | Supraspinatus Tear. Available from: https://www.youtube.com/watch?v=JXgRBeqToik [last accessed 3/7/17]
- ↑ Jain NB, Wilcox III RB, Katz JN, Higgins LD. Clinical examination of the rotator cuff. PM&R. 2013 Jan 1;5(1):45-56.
- ↑ 5.0 5.1 5.2 Miller CA, Forrester GA, Lewis JS. The validity of the lag signs in diagnosing full-thickness tears of the rotator cuff: a preliminary investigation. Archives of physical medicine and rehabilitation. 2008 Jun 1;89(6):1162-8.
- ↑ 6.0 6.1 Jain NB, Luz J, Higgins LD, Dong Y, Warner JJ, Matzkin E, Katz JN. The diagnostic accuracy of special tests for rotator cuff tear: the ROW cohort study. American journal of physical medicine & rehabilitation. 2017 Mar;96(3):176.
- ↑ Lädermann A, Meynard T, Denard PJ, Ibrahim M, Saffarini M, Collin P. Reliable diagnosis of posterosuperior rotator cuff tears requires a combination of clinical tests. Knee Surgery, Sports Traumatology, Arthroscopy. 2020 Jul 28:1-6.
