Roos Stress Test: Difference between revisions

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== Purpose<br>  ==
== Purpose<br>  ==


This test is a diagnostic tool used in the identification of [[Thoracic Outlet Syndrome (TOS)|Thoracic Outlet Syndrome (TOS)]]<br>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)]]<br>It is also known as the “elevated arm stress test” or "EAST".<br>  


== Clinically Relevant Anatomy  ==
== Clinically Relevant Anatomy  ==
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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<br>  ==
== Technique ==


Starting postion: <ref>Brantigan CO, Roos DB. Diagnosing thoracic outlet syndrome. Hand Clin. 2004 Feb;20(1):27-36. (evidence level E)</ref><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>  
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Possible results in case of orthopedic shoulder problems:  
Possible results in case of orthopedic shoulder problems:  


*Intolerable symptoms confined to shoulder area<br>
*Intolerable symptoms confined to shoulder area
 
{| width="100%" cellspacing="1" cellpadding="1" class="FCK__ShowTableBorders"
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| {{#ev:youtube|_dDWNQG1jB0|300}} <ref>Roos Test. Online video available from: https://www.youtube.com/watch?v=_dDWNQG1jB0, last accessed 07/04/2013]</ref>
| {{#ev:youtube|4Jug2ByFRtM|300}}<ref>Physical Therapy Nation. Roos Test for Thoraci Outlet. Available from: http://www.youtube.com/watch?v=4Jug2ByFRtM [last accessed 14/12/13]</ref>
|}


<br>  
<br>  
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== 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>
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>  


== Resources <br>  ==
== Resources <br>  ==
{{#ev:youtube|_dDWNQG1jB0|250}} <ref>Roos Test. Online video available from: https://www.youtube.com/watch?v=_dDWNQG1jB0, last accessed 07/04/2013</ref>


== Clinical Bottom Line  ==
== Clinical Bottom Line  ==
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== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
<div class="researchbox">
<div class="researchbox">
<rss>http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1VcNN1T1Quu_znqhhvEGY-Wm8-ovh9-Mezyu3c4fpa1MGZFsaB|charset=UTF-8|short|max=10</rss>
<rss>http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1VcNN1T1Quu_znqhhvEGY-Wm8-ovh9-Mezyu3c4fpa1MGZFsaB|charset=UTF-8|short|max=10</rss>  
</div class>
</div>  
 
== References  ==
== References  ==


<references />  
<references />  


[[Category:Special_Tests|Template:VUBTest]] [[Category:Musculoskeletal/Orthopaedics]]
[[Category:Special_Tests|Template:VUBTest]] [[Category:Musculoskeletal/Orthopaedics]] [[Category: Videos]]

Revision as of 19:50, 14 December 2013

Original Editors - Yves Hubar

Top Contributors - Evan Thomas, Yves Hubar, Admin, Rachael Lowe, Kim Jackson, WikiSysop, Claire Knott, Wanda van Niekerk, Tony Lowe, Laura Ritchie, Naomi O'Reilly and Kai A. Sigel  

Search Strategy
[edit | edit source]

Literature was found using pubmed.

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 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
[2]
[3]


Diagnostic accuracy:[4]

  • 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]

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.

Resources
[edit | edit source]

Clinical Bottom Line[edit | edit source]

add text here

Recent Related Research (from Pubmed)[edit | edit source]

Failed to load RSS feed from http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1VcNN1T1Quu_znqhhvEGY-Wm8-ovh9-Mezyu3c4fpa1MGZFsaB|charset=UTF-8|short|max=10: Error parsing XML for RSS

References[edit | edit source]

  1. ↑ Brantigan CO, Roos DB. Diagnosing thoracic outlet syndrome. Hand Clin. 2004 Feb;20(1):27-36. (evidence level E)
  2. ↑ Roos Test. Online video available from: https://www.youtube.com/watch?v=_dDWNQG1jB0, last accessed 07/04/2013]
  3. ↑ Physical Therapy Nation. Roos Test for Thoraci Outlet. Available from: http://www.youtube.com/watch?v=4Jug2ByFRtM [last accessed 14/12/13]
  4. ↑ 2: Lee J, Laker S, Fredericson M. Thoracic outlet syndrome. PM R. 2010 Jan;2(1):64-70. (Grade of evidence E)
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