Roos Stress Test

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Original Editors - Yves Hubar

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Search Strategy

Literature was found using pubmed.

Definition/Description

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Clinically Relevant Anatomy

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Purpose

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

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:

• Sensitivity: 84%
• Specificity: 30%
• PPV: 68%
• NPV: 50%

Reliability:

• Inter and intra-examiner reliability have not yet been found in literature.

Key Research

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Resources

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Clinical Bottom Line

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Recent Related Research (from Pubmed)

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References

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