Infraspinatus Test: Difference between revisions

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== Purpose  ==
== Purpose  ==


The Infraspinatus test is used to test for [[Subacromial Impingement|subacromial impingement]] or [[Rotator Cuff Tears|rotator cuff tears]].<br>  
The [[Infraspinatus|infraspinatus muscle]] is one of the rotator cuff muscles. Rotator cuff muscles dysfunction leads to shoulder impingement as the head of the humorous superiorly migrates during arm elevation. Infrapinatus muscle is often involved in shoulder pathologies as shoulder impingement and rotator cuff tears.<ref name=":0">Hughes PC, Green RA, Taylor NF. Isolation of infraspinatus in clinical test positions. Journal of science and medicine in sport. 2014 May 1;17(3):256-60.</ref>


== Technique<ref>Flynn, T.W., Cleland, J.A., and Whitman, J.M. (2008). User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. Buckner, Kentucky: Evidence in Motion</ref> ==
The Infraspinatus test is used to test for infraspinatus muscle involvment in rotator cuff pathologies such as [[Subacromial Impingement|subacromial impingement]] or [[Rotator Cuff Tears|rotator cuff tears]].<ref name=":0" />  


The patient should be standing, with the arm in a neutral position and the elbow flexed to 90 degrees. The therapist will apply a medially directed force to the arm while the patient is instructed to resist. The test is considered positive if the patient reports pain or weakness when resistance is applied.<br>
== Technique ==


{{#ev:youtube|xVQy0qPU3Ho|300}}<ref>Physical Therapy Haven. Infraspinatus Test. Available from: https://www.youtube.com/watch?v=xVQy0qPU3Ho [last accessed 15/3/15]</ref>
The patient arms should be at his side not quite touching his trunk, with the elbows flexed to 90 degrees. The examiner places his hand on the dorsum of the patient’s hands. The patient is asked to externally rotate both forearms against the examiner’s resistance.


<br>  
The test is positive when there is weakness or pain in external rotation. Infraspinatus tears are usually painless so external rotation weakness strongly suggests infraspinatus tear.<ref name=":1">Micheroli R, Kyburz D, Ciurea A, Dubs B, Toniolo M, Bisig SP, Tamborrini G. Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder. Journal of ultrasonography. 2015 Mar;15(60):29.</ref>
 
{{#ev:youtube|gPDN7XIA-KI}}<ref> Tim Fraticelli - PTProgress. Infraspinatus Test | Rotator Cuff Tendonitis or Tear
. Available from: http://www. https://www.youtube.com/watch?v=gPDN7XIA-KI [last accessed 13/7/2021]</ref>


== Evidence  ==
== Evidence  ==


'''Test Item Cluster:'''<br> This test may be combined as a cluster with the [[Hawkins / Kennedy Test|Hawkins-Kennedy Impingement Sign]] and the [[Painful Arc|Painful Arc]] sign to test for [[Subacromial Impingement|subacromial impingement]]. If all three tests report a positive, then the positive likelihood ratio is 10.56 and if all three tests are negative, the negative likelihood ratio is 0.17. If two of the three tests are positive, then the positive likelihood ratio is 5.03.<ref>Park, H.B., Yokota, A., Gill, H.S., EI RG, McFarland, E.G. (2005). Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am, 87(7), 1446-1455.</ref>  
The infraspinatus test showed a high sensitivity of 0.90 and specificity of 0.74.<ref name=":1" />
 
'''Test Item Cluster:'''<br> This test may be combined as a cluster with the [[Hawkins / Kennedy Test|Hawkins-Kennedy Impingement Sign]] and the [[Painful Arc]] sign to test for [[Subacromial Impingement|subacromial impingement]]. If all three tests report a positive, then the positive likelihood ratio is 10.56 and if all three tests are negative, the negative likelihood ratio is 0.17. If two of the three tests are positive, then the positive likelihood ratio is 5.03.<ref>Park, H.B., Yokota, A., Gill, H.S., EI RG, McFarland, E.G. (2005). Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am, 87(7), 1446-1455.</ref>  


'''Test Item Cluster:'''<br>This test may be combined as a cluster with the [[Codman's Test|Drop-Arm Sign]] and the [[Painful Arc|Painful Arc Sign]] to test for the presence of a full-thickness [[Rotator Cuff Tears|rotator cuff tear]]. If all three tests report positive results, then the positive likelihood ratio is 15.6 and if all three tests are negative, the negative likelihood ratio is 0.16. If all three tests are positive and the patient is older than 60 years, th positive likelihood ratio is 28.0. If two of three tests are positive, the positive likelihood ratio is 3.60.<ref>Park, H.B., Yokota, A., Gill, H.S., EI RG, McFarland, E.G. (2005). Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am, 87(7), 1446-1455.</ref>  
'''Test Item Cluster:'''<br>This test may be combined as a cluster with the [[Codman's Test|Drop-Arm Sign]] and the [[Painful Arc|Painful Arc Sign]] to test for the presence of a full-thickness [[Rotator Cuff Tears|rotator cuff tear]]. If all three tests report positive results, then the positive likelihood ratio is 15.6 and if all three tests are negative, the negative likelihood ratio is 0.16. If all three tests are positive and the patient is older than 60 years, th positive likelihood ratio is 28.0. If two of three tests are positive, the positive likelihood ratio is 3.60.<ref>Park, H.B., Yokota, A., Gill, H.S., EI RG, McFarland, E.G. (2005). Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am, 87(7), 1446-1455.</ref>  


<br> See [[Test Diagnostics|test diagnostics]] page for explanation of statistics.  
<br> See [[Test Diagnostics|test diagnostics]] page for explanation of statistics.
 
== References  ==
== References  ==


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[[Category:Sports Medicine]]
[[Category:Sports Medicine]]
[[Category:Athlete Assessment]]
[[Category:Athlete Assessment]]
[[Category:Assessment]]

Latest revision as of 15:11, 13 July 2021

Purpose[edit | edit source]

The infraspinatus muscle is one of the rotator cuff muscles. Rotator cuff muscles dysfunction leads to shoulder impingement as the head of the humorous superiorly migrates during arm elevation. Infrapinatus muscle is often involved in shoulder pathologies as shoulder impingement and rotator cuff tears.[1]

The Infraspinatus test is used to test for infraspinatus muscle involvment in rotator cuff pathologies such as subacromial impingement or rotator cuff tears.[1]

Technique[edit | edit source]

The patient arms should be at his side not quite touching his trunk, with the elbows flexed to 90 degrees. The examiner places his hand on the dorsum of the patient’s hands. The patient is asked to externally rotate both forearms against the examiner’s resistance.

The test is positive when there is weakness or pain in external rotation. Infraspinatus tears are usually painless so external rotation weakness strongly suggests infraspinatus tear.[2]

[3]

Evidence[edit | edit source]

The infraspinatus test showed a high sensitivity of 0.90 and specificity of 0.74.[2]

Test Item Cluster:
This test may be combined as a cluster with the Hawkins-Kennedy Impingement Sign and the Painful Arc sign to test for subacromial impingement. If all three tests report a positive, then the positive likelihood ratio is 10.56 and if all three tests are negative, the negative likelihood ratio is 0.17. If two of the three tests are positive, then the positive likelihood ratio is 5.03.[4]

Test Item Cluster:
This test may be combined as a cluster with the Drop-Arm Sign and the Painful Arc Sign to test for the presence of a full-thickness rotator cuff tear. If all three tests report positive results, then the positive likelihood ratio is 15.6 and if all three tests are negative, the negative likelihood ratio is 0.16. If all three tests are positive and the patient is older than 60 years, th positive likelihood ratio is 28.0. If two of three tests are positive, the positive likelihood ratio is 3.60.[5]


See test diagnostics page for explanation of statistics.

References[edit | edit source]

  1. 1.0 1.1 Hughes PC, Green RA, Taylor NF. Isolation of infraspinatus in clinical test positions. Journal of science and medicine in sport. 2014 May 1;17(3):256-60.
  2. 2.0 2.1 Micheroli R, Kyburz D, Ciurea A, Dubs B, Toniolo M, Bisig SP, Tamborrini G. Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder. Journal of ultrasonography. 2015 Mar;15(60):29.
  3. Tim Fraticelli - PTProgress. Infraspinatus Test | Rotator Cuff Tendonitis or Tear . Available from: http://www. https://www.youtube.com/watch?v=gPDN7XIA-KI [last accessed 13/7/2021]
  4. Park, H.B., Yokota, A., Gill, H.S., EI RG, McFarland, E.G. (2005). Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am, 87(7), 1446-1455.
  5. Park, H.B., Yokota, A., Gill, H.S., EI RG, McFarland, E.G. (2005). Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am, 87(7), 1446-1455.