Roos Stress Test: Difference between revisions
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'''Original Editors ''' - [[User:Yves Hubar|Yves Hubar]] | '''Original Editors ''' - [[User:Yves Hubar|Yves Hubar]] | ||
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | ||
</div> | </div> | ||
== Purpose == | |||
This test is a diagnostic tool used in the identification of [[Thoracic Outlet Syndrome (TOS)|Thoracic Outlet Syndrome (TOS)]]. It is also known as the “elevated arm stress test” or "EAST".<br> | |||
This test is a diagnostic tool used in the identification of [[Thoracic Outlet Syndrome (TOS)|Thoracic Outlet Syndrome (TOS)]] | |||
== Clinically Relevant Anatomy == | == Clinically Relevant Anatomy == | ||
| Line 16: | Line 13: | ||
Please refer to the [[Thoracic Outlet Syndrome (TOS)|Thoracic Outlet Syndrome (TOS)]] page. | Please refer to the [[Thoracic Outlet Syndrome (TOS)|Thoracic Outlet Syndrome (TOS)]] page. | ||
== Technique | == Technique == | ||
*The patient has both arms in the 90° abduction-external rotation | Starting postion: <ref>Brantigan CO, Roos DB. Diagnosing thoracic outlet syndrome. Hand Clin. 2004 Feb;20(1):27-36. (evidence level E)</ref> | ||
*The patient has both arms in the 90° abduction-external rotation position | |||
*Shoulders and elbows are in the frontal plane of the chest | *Shoulders and elbows are in the frontal plane of the chest | ||
<br> | |||
Execution: | Execution: | ||
*The patient is to open and close the hands slowly over a 3-minute period | *The patient is to open and close the hands slowly over a 3-minute period | ||
<br> | |||
Results if normal: | Results if normal: | ||
*Only forearm muscle fatigue and minimal distress | *Only forearm muscle fatigue and minimal distress | ||
<br> | |||
Possible symptoms if TOS is present: | Possible symptoms if TOS is present: | ||
*gradual increase in pain at neck and shoulder, progressing down the arm | *gradual increase in pain at neck and shoulder, progressing down the arm | ||
*Paraesthesia in forearm and fingers | *Paraesthesia in forearm and fingers | ||
*In case of arterial compression: arm pallor with arm elevated, reactive hyperemia when limb is lowered | *In case of arterial compression: arm pallor with arm elevated, reactive hyperemia when limb is lowered | ||
*In case of | *In case of venous compression: Cyanosis and swelling | ||
*Inability to complete test, and patient drops arms in lap in marked distress, recognized as reproduction of usual symptoms | *Inability to complete test, and patient drops arms in lap in marked distress, recognized as reproduction of usual symptoms | ||
*'''Reproduction of the usual symptoms that involve the entire extremity!''' | *'''Reproduction of the usual symptoms that involve the entire extremity!''' | ||
<br> | |||
Possible results if [[Carpel Tunnel Syndrome|carpal tunnel syndrome]] is present: | Possible results if [[Carpel Tunnel Syndrome|carpal tunnel syndrome]] is present: | ||
*Numbness in first three fingers due to compression of nervus medianus | *Numbness in first three fingers due to compression of nervus medianus | ||
<br> | |||
Possible results in case of cervical disc syndrome: | Possible results in case of cervical disc syndrome: | ||
*Pain in neck and shoulder from holding arms elevated but minimal distress in arm or hand. | *Pain in neck and shoulder from holding arms elevated but minimal distress in arm or hand. | ||
<br> | |||
Possible results in case of orthopedic shoulder problems: | Possible results in case of orthopedic shoulder problems: | ||
*Intolerable symptoms confined to shoulder area | |||
<br> | |||
{{#ev:youtube|_dDWNQG1jB0|300}} | |||
{{#ev:youtube|4Jug2ByFRtM|300}} | |||
Diagnostic accuracy:<ref>2: Lee J, Laker S, Fredericson M. Thoracic outlet syndrome. PM R. 2010 Jan;2(1):64-70. (Grade of evidence E)</ref> | |||
*Sensitivity: 84% | *Sensitivity: 84% | ||
*Specificity: 30% | *Specificity: 30% | ||
*PPV: 68% | *PPV: 68% | ||
*NPV: 50% | *NPV: 50% | ||
<br> | |||
Reliability: | Reliability: | ||
*Inter and intra-examiner reliability have not yet been found in the literature. | |||
*Inter and intra-examiner reliability have not yet been found in literature. | <br> | ||
== Key Research == | == Key Research == | ||
Gillard J, Pérez-Cousin M, Hachulla É, Remy J, Hurtevent JF, Vinckier L, Thévenon A, Duquesnoy B. Diagnosing thoracic outlet syndrome: contribution of provocative tests, ultrasonography, electrophysiology, and helical computed tomography in 48 patients. Joint Bone Spine, 2001; 68(5): 416-424.<br> | |||
== References == | == References == | ||
<references /> | <references /> | ||
[[Category:Special_Tests]] | |||
[[Category: | [[Category:Shoulder]] | ||
[[Category:Shoulder - Special Tests]] | |||
[[Category:Shoulder - Assessment and Examination]] | |||
[[Category:Musculoskeletal/Orthopaedics]] | |||
[[Category:Primary Contact]] | |||
[[Category:Sports Medicine]] | |||
[[Category:Athlete Assessment]] | |||
[[Category:Assessment]] | |||
[[Category:Thoracic Spine - Special Tests]] | |||
Latest revision as of 22:25, 31 January 2021
Original Editors - Yves Hubar
Top Contributors - Evan Thomas, Yves Hubar, Admin, Rachael Lowe, Kim Jackson, WikiSysop, Tony Lowe, Laura Ritchie, Naomi O'Reilly, Kai A. Sigel, Claire Knott and Wanda van Niekerk
Purpose[edit | edit source]
This test is a diagnostic tool used in the identification of Thoracic Outlet Syndrome (TOS). It is also known as the “elevated arm stress test” or "EAST".
Clinically Relevant Anatomy[edit | edit source]
Please refer to the Thoracic Outlet Syndrome (TOS) page.
Technique[edit | edit source]
Starting postion: [1]
- The patient has both arms in the 90° abduction-external rotation position
- Shoulders and elbows are in the frontal plane of the chest
Execution:
- The patient is to open and close the hands slowly over a 3-minute period
Results if normal:
- Only forearm muscle fatigue and minimal distress
Possible symptoms if TOS is present:
- gradual increase in pain at neck and shoulder, progressing down the arm
- Paraesthesia in forearm and fingers
- In case of arterial compression: arm pallor with arm elevated, reactive hyperemia when limb is lowered
- In case of venous compression: Cyanosis and swelling
- Inability to complete test, and patient drops arms in lap in marked distress, recognized as reproduction of usual symptoms
- Reproduction of the usual symptoms that involve the entire extremity!
Possible results if carpal tunnel syndrome is present:
- Numbness in first three fingers due to compression of nervus medianus
Possible results in case of cervical disc syndrome:
- Pain in neck and shoulder from holding arms elevated but minimal distress in arm or hand.
Possible results in case of orthopedic shoulder problems:
- Intolerable symptoms confined to shoulder area
Diagnostic accuracy:[2]
- Sensitivity: 84%
- Specificity: 30%
- PPV: 68%
- NPV: 50%
Reliability:
- Inter and intra-examiner reliability have not yet been found in the literature.
Key Research[edit | edit source]
Gillard J, Pérez-Cousin M, Hachulla É, Remy J, Hurtevent JF, Vinckier L, Thévenon A, Duquesnoy B. Diagnosing thoracic outlet syndrome: contribution of provocative tests, ultrasonography, electrophysiology, and helical computed tomography in 48 patients. Joint Bone Spine, 2001; 68(5): 416-424.
