Roos Stress Test: Difference between revisions
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This test is a diagnostic tool used in the identification of Thoracic outlet syndrome<br>It is also known as the “elevated arm stress test”.<br> | This test is a diagnostic tool used in the identification of Thoracic outlet syndrome<br>It is also known as the “elevated arm stress test”.<br> | ||
== Technique | == Technique<br> == | ||
Starting postion: <br> | Starting postion: <ref>Brantigan CO, Roos DB. Diagnosing thoracic outlet syndrome. Hand Clin. 2004 Feb;20(1):27-36. (evidence level E)</ref><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 | ||
Line 56: | Line 56: | ||
*Intolerable symptoms confined to shoulder area<br> | *Intolerable symptoms confined to shoulder area<br> | ||
<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> | 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% | *Sensitivity: 84% | ||
*Specificity: 30% | *Specificity: 30% | ||
*PPV: 68% | *PPV: 68% | ||
*NPV: 50% | *NPV: 50% | ||
Reliability: | Reliability: | ||
*Inter and intra-examiner reliability have not yet been found in literature. | *Inter and intra-examiner reliability have not yet been found in literature. |
Revision as of 23:06, 31 May 2011
Original Editors - Yves Hubar
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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
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Starting postion: [1]
- 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.
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