Jobes Relocation Test: Difference between revisions

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'''Original Editor '''- [[User:Tyler Shultz|Tyler Shultz]]
'''Original Editor '''- [[User:Tyler Shultz|Tyler Shultz]]


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'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}       
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== Purpose<br>  ==
== Purpose   ==


The purpose of the Jobes Relocation Test is to test for anterior instability of the [[Glenohumeral Joint|glenohumeral joint]].<br>
The purpose of the Jobe Relocation Test<ref>Jobe FW, Kvitne RS, Giangarra CE: Shoulder pain in the overhand or throwing athlete: The relationship of anterior instability and rotator cuff impingement. Orthop Rev 18: 963–975,1989.</ref> (also referred to as the Fowler Sign) is to test for anterior instability of the [[Glenohumeral Joint|glenohumeral joint]].  


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


This test is extremely similar in nature to the [[Apprehension Test|Apprehension test]], and is often administered after the Apprehension test produces a positive result.&nbsp; The patient is positioned supine, with the elbow flexed to 90 degrees and abducted to 90 degrees.&nbsp; The therapist then applies an external rotation force to the shoulder, if the patient reports apprehension in any way, the [[Apprehension Test|apprehension test]] is considered to be positive.&nbsp; At this point, the therapist may apply a posteriorly directed force to the shoulder - if the patient's apprehension or pain is reduced in this position, the Jobes Relocation test is considered to be positive<ref>Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.</ref>.&nbsp; It is important to note that the therapist should always release the relocation force before releasing the patient back into neutral rotation for risk of [[Shoulder Dislocation|shoulder dislocation]].  
This test is extremely similar in nature to the [[Apprehension Test|Apprehension Test]], and is often administered after the Apprehension Test, to investigate a positive result.&nbsp; The patient is positioned supine, with the elbow flexed to 90 degrees and abducted to 90 degrees.&nbsp; The therapist then applies an external rotation force to the shoulder, if the patient reports apprehension in any way, the [[Apprehension Test|Apprehension Test]] is considered to be positive.&nbsp; At this point, the therapist may apply a posteriorly directed force to the shoulder - if the patient's apprehension or pain is reduced in this position, the Jobe Relocation Test is considered to be positive<ref>Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.</ref>.&nbsp; It is important to note that the therapist should always bring the arm back into a neutral position before releasing the relocation force (posterior glide of the head of the humerus) for risk of [[Shoulder Dislocation|shoulder dislocation]].  


{{#ev:youtube|JkO8nnWFIwM}}<ref>Physiotutors. Shoulder Relocation Test | Shoulder Instability. Available from: https://www.youtube.com/watch?v=JkO8nnWFIwM</ref>
If the patient's symptoms decrease or are eliminated when performing the Jobe Relocation Test, the possible diagnoses include: glenohumeral instability, subluxation, dislocation or impingement.


== Evidence  ==
If the apprehension predominated when performing the Crank Test and disappears with the Jobe Relocation Test, the diagnosis can include a pseudolaxity ot anterior instability of the GH joint, or potentially the scapulothoracic joint. It is important to also consider a secondary impingement or a posterior SLAP labral legion. 


Provide the evidence for this technique here
{{#ev:youtube|qKqJRrms4u8|300}} 
{{#ev:youtube|gLBX8vUnCo0|300}}


<div class="researchbox">
== Test Accuracy / Reliability / Evidence:  ==
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
Sensitivity and Specificity & Likelihood Ratio:<ref>Farber AJ, Castillo R, Clough M, et al: Clinical assessment of three common tests for traumatic anterior shoulder instability. J Bone Joint Surg Am 2006; 88: pp. 1467-1474.</ref>


<rss>http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1zUzxRRMg0kTyfwuVlT85pKV9GVMKVi6gkImkJS9t-MMsIYAk</rss>
'''Sensitivity = 0.30''' (the ability of the test to rule a diagnosis IN, also understood as the true positive rate)
</div>
 
'''Specificity = 0.90''' (the ability of the test to rule a diagnosis OUT, also understood as the true negative rate)
 
'''+LR = 3.0.''' (sensitivity / 1- specificity)
 
'''– LR = 0.77''' (1- sensitivity / specificity)
== References  ==
== References  ==


<references />
<references />


   [[Category:Special_Tests]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Shoulder]] [[Category:Videos]]
   [[Category:Special_Tests]]  
[[Category:Shoulder - Special Tests]]
[[Category:Shoulder - Assessment and Examination]]
[[Category:Musculoskeletal/Orthopaedics]]  
[[Category:Shoulder]]  
[[Category:Primary Contact]]
[[Category:Sports Medicine]]
[[Category:Athlete Assessment]]
[[Category:Assessment]]

Latest revision as of 14:29, 24 July 2020

Original Editor - Tyler Shultz

Top Contributors - Rachael Lowe, Admin, Kim Jackson, Tyler Shultz, Amanda Ager, Kai A. Sigel, WikiSysop, Claire Knott, Wanda van Niekerk, Tony Lowe, Naomi O'Reilly and George Prudden  

Purpose[edit | edit source]

The purpose of the Jobe Relocation Test[1] (also referred to as the Fowler Sign) is to test for anterior instability of the glenohumeral joint.

Technique[edit | edit source]

This test is extremely similar in nature to the Apprehension Test, and is often administered after the Apprehension Test, to investigate a positive result.  The patient is positioned supine, with the elbow flexed to 90 degrees and abducted to 90 degrees.  The therapist then applies an external rotation force to the shoulder, if the patient reports apprehension in any way, the Apprehension Test is considered to be positive.  At this point, the therapist may apply a posteriorly directed force to the shoulder - if the patient's apprehension or pain is reduced in this position, the Jobe Relocation Test is considered to be positive[2].  It is important to note that the therapist should always bring the arm back into a neutral position before releasing the relocation force (posterior glide of the head of the humerus) for risk of shoulder dislocation.

If the patient's symptoms decrease or are eliminated when performing the Jobe Relocation Test, the possible diagnoses include: glenohumeral instability, subluxation, dislocation or impingement.

If the apprehension predominated when performing the Crank Test and disappears with the Jobe Relocation Test, the diagnosis can include a pseudolaxity ot anterior instability of the GH joint, or potentially the scapulothoracic joint. It is important to also consider a secondary impingement or a posterior SLAP labral legion.

Test Accuracy / Reliability / Evidence:[edit | edit source]

Sensitivity and Specificity & Likelihood Ratio:[3]

Sensitivity = 0.30 (the ability of the test to rule a diagnosis IN, also understood as the true positive rate)

Specificity = 0.90 (the ability of the test to rule a diagnosis OUT, also understood as the true negative rate)

+LR = 3.0. (sensitivity / 1- specificity)

– LR = 0.77 (1- sensitivity / specificity)

References[edit | edit source]

  1. ↑ Jobe FW, Kvitne RS, Giangarra CE: Shoulder pain in the overhand or throwing athlete: The relationship of anterior instability and rotator cuff impingement. Orthop Rev 18: 963–975,1989.
  2. ↑ Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
  3. ↑ Farber AJ, Castillo R, Clough M, et al: Clinical assessment of three common tests for traumatic anterior shoulder instability. J Bone Joint Surg Am 2006; 88: pp. 1467-1474.
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