Roos Stress Test: Difference between revisions
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== Technique<ref>Brantigan CO, Roos DB. Diagnosing thoracic outlet syndrome. Hand Clin. 2004 Feb;20(1):27-36.</ref><br> == | == Technique<ref>Brantigan CO, Roos DB. Diagnosing thoracic outlet syndrome. Hand Clin. 2004 Feb;20(1):27-36.</ref><br> == | ||
Starting postion: <br> | Starting postion: <br> | ||
*The patient has both arms in the 90° abduction-external rotation postion | *The patient has both arms in the 90° abduction-external rotation postion | ||
*Shoulders and elbows are in the frontal plane of the chest | *Shoulders and elbows are in the frontal plane of the chest | ||
Execution:<br> | Execution:<br> | ||
*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 | ||
Results if normal:<br> | Results if normal:<br> | ||
*Only forearm muscle fatigue and minimal distress | *Only forearm muscle fatigue and minimal distress | ||
Possible symptoms if TOS is present:<br> | Possible symptoms if TOS is present:<br> | ||
*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 vernous compression: Cyanosis and swelling | *In case of vernous 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!''' | ||
Possible results if carpal tunnel syndrome is present:<br> | Possible results if carpal tunnel syndrome is present:<br> | ||
*Numbness in first three fingers due to compression of nervus medianus | *Numbness in first three fingers due to compression of nervus medianus | ||
Possible results in case of cervical disc syndrome:<br> | Possible results in case of cervical disc syndrome:<br> | ||
*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. | ||
Possible results in case of orthopedic shoulder problems: | Possible results in case of orthopedic shoulder problems: | ||
*Intolerable symptoms confined to shoulder area | *Intolerable symptoms confined to shoulder area<br> | ||
<br> | |||
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><br> | |||
*Sensitivity: 84% | |||
*Specificity: 30% | |||
*PPV: 68% | |||
*NPV: 50% | |||
Reliability: | |||
*Inter and intra-examiner reliability have not yet been found in literature. | |||
== Key Research == | == Key Research == |
Revision as of 23:00, 31 May 2011
Original Editors - Yves Hubar
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Definition/Description[edit | edit source]
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Purpose
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This test is a diagnostic tool used in the identification of Thoracic outlet syndrome
It is also known as the “elevated arm stress test”.
Technique[1]
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Starting postion:
- The patient has both arms in the 90° abduction-external rotation postion
- 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 vernous 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 literature.
Key Research[edit | edit source]
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Clinical Bottom Line[edit | edit source]
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