Subacromial Impingement Cluster: Difference between revisions
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'''Original Editor '''- [[User:Stacy Callow|Stacy Callow]] | '''Original Editor '''- [[User:Stacy Callow|Stacy Callow]] | ||
''' | '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | ||
</div> | </div> | ||
== Purpose == | == Purpose == | ||
To test for the presence of subacromial impingement | To test for the presence of [https://physio-pedia.com/Subacromial_Pain_Syndrome#share subacromial impingement] | ||
== Tests for Subacromial Impingement<ref name="Michener">Michener LA, Walsworth MK, Doukas WC, Murphy KP. Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. Arch Phys Med Rehabil. 2009 Nov;90(11):1898-903.</ref><ref name="Park">Park HB, Yokota A, Gill HS, El Rassi G, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am. 2005 Jul;87(7):1446-55.</ref> == | == Tests for Subacromial Impingement<ref name="Michener">Michener LA, Walsworth MK, Doukas WC, Murphy KP. Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. Arch Phys Med Rehabil. 2009 Nov;90(11):1898-903.</ref><ref name="Park">Park HB, Yokota A, Gill HS, El Rassi G, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am. 2005 Jul;87(7):1446-55.</ref> == | ||
'''Hawkins-Kennedy''': SN: .63 (.39–.86) SP: .62 (.46–.77) +LR: 1.63 (.94–2.81) | '''[https://physio-pedia.com/Hawkins_/_Kennedy_Impingement_Test_of_the_Shoulder#share Hawkins-Kennedy]''': Sensitivity (SN): .63 (.39–.86) Specificity(SP): .62 (.46–.77), Likelihood ratio(+LR): 1.63 (.94–2.81) | ||
*Testing: Shoulder is flexed to 90 degrees and then internally rotated with elbow flexed to 90 degrees. | *Testing: Shoulder is flexed to 90 degrees and then internally rotated with elbow flexed to 90 degrees. | ||
*Positive Test: Pain with IR. | *Positive Test: Pain with IR. | ||
'''Neer''': SN: .81 (.62–1.0) SP: .54 (.38–.69) +LR: 1.76 (1.17–2.66) | '''[https://physio-pedia.com/Neers_Test#share Neer]''': SN: .81 (.62–1.0) SP: .54 (.38–.69) +LR: 1.76 (1.17–2.66) | ||
*Testing: Examiner stablizers scapula and flexes shoulder until pain is felt or end of ROM. | *Testing: Examiner stablizers scapula and flexes shoulder until pain is felt or end of ROM. | ||
*Positive Test: Pain with flexion | *Positive Test: Pain with flexion | ||
'''Painful arc''': SN: .75 (.54–.96) SP: .67 (.52–.81) +LR: 2.25 (1.33–3.81) | '''[https://physio-pedia.com/Painful_Arc#share Painful arc]''': SN: .75 (.54–.96) SP: .67 (.52–.81) +LR: 2.25 (1.33–3.81) | ||
*Testing: Shoulder is elevated in | *Testing: Shoulder is elevated in scapular plane abduction to full elevation and then lowered in same motion. | ||
*Positive Test: Pain or pain from 60 to 120 degrees | *Positive Test: Pain or pain from 60 to 120 degrees scapular plane abduction | ||
'''Empty can | '''[https://physio-pedia.com/Empty_Can_Test#share Empty can]: '''SN: .50 (.26–.75) SP: .87 (.77–.98) +LR: 3.90 (1.50–10.12) | ||
*Testing: Shoulder abducted to 90 degrees and slightly adducted. Shoulder internally rotated and downward force applied. | *Testing: Shoulder abducted to 90 degrees and slightly adducted. Shoulder internally rotated and downward force applied. | ||
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*Positive Test: Pain with adduction | *Positive Test: Pain with adduction | ||
'''Drop arm sign''': SN: .27 SP: .88 | '''[https://physio-pedia.com/Drop_Arm_Test#share Drop arm sign]''': SN: .27 SP: .88 | ||
*Testing: Shoulder is elevated to full flexion and asked to slowly lower. | *Testing: Shoulder is elevated to full flexion and asked to slowly lower. | ||
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== Clusters == | == Clusters == | ||
If three of the following test are positive: Hawkins-Kennedy, neer, painful arc, empty can, and external rotation resistance then SN: .75 (.54–.96) SP: .74 (.61–.88) +LR: 2.93 (1.60–5.36) -LR: .34 (.14–.80)<ref name="Michener" /> | If three of the following test are positive: Hawkins-Kennedy, neer, painful arc, empty can, and external rotation resistance then SN: .75 (.54–.96) SP: .74 (.61–.88) +LR: 2.93 (1.60–5.36) -LR: .34 (.14–.80)<ref name="Michener" /> | ||
If | If Painful arc sign, Drop-arm sign, Infraspinatus muscle test positive the +LR: 15.57 of full thickness rotator cuff tear<ref name="Park" /> | ||
If Hawkins-Kennedy impingement sign, | If Hawkins-Kennedy impingement sign, Painful arc sign, Infraspinatus muscle test positive then +LR: 10.56 of some type of impingement present<ref name="Park" /> | ||
'''Painful arc, empty can and external rotation resistance''' are the (2 or more tests are positive) best combination for the diagnosis of [https://physio-pedia.com/Subacromial_Pain_Syndrome#share Subacromial Impingement Syndrome.]<ref name=":0">Chen CW, Pan ZE, Zhang C, Liu CL, Chen L. ''Zhongguo Gu Shang''. 2016;29(5):434-438.</ref> | |||
< | |||
< | '''Painful arc and external rotation resistance''' are the (both tests are negative) best combination for ruling out [https://physio-pedia.com/Subacromial_Pain_Syndrome#share Subacromial Impingement Syndrome.]<ref name=":0" /><br> | ||
< | |||
References | == References == | ||
<references /> | <references /> | ||
[[Category: | [[Category:Assessment]] | ||
[[Category:EIM_Residency_Project]] | |||
[[Category:Musculoskeletal/Orthopaedics]] | |||
[[Category:Shoulder]] | |||
[[Category:Sports Medicine]] | |||
[[Category:Athlete Assessment]] | |||
[[Category:Clinical Prediction Rules]] |
Latest revision as of 10:52, 8 December 2020
Original Editor - Stacy Callow
Top Contributors - Admin, Stacy Callow, Tony Lowe, Anas Mohamed, Selena Horner, Kai A. Sigel, WikiSysop, Wanda van Niekerk and Manisha Shrestha
Purpose[edit | edit source]
To test for the presence of subacromial impingement
Tests for Subacromial Impingement[1][2][edit | edit source]
Hawkins-Kennedy: Sensitivity (SN): .63 (.39–.86) Specificity(SP): .62 (.46–.77), Likelihood ratio(+LR): 1.63 (.94–2.81)
- Testing: Shoulder is flexed to 90 degrees and then internally rotated with elbow flexed to 90 degrees.
- Positive Test: Pain with IR.
Neer: SN: .81 (.62–1.0) SP: .54 (.38–.69) +LR: 1.76 (1.17–2.66)
- Testing: Examiner stablizers scapula and flexes shoulder until pain is felt or end of ROM.
- Positive Test: Pain with flexion
Painful arc: SN: .75 (.54–.96) SP: .67 (.52–.81) +LR: 2.25 (1.33–3.81)
- Testing: Shoulder is elevated in scapular plane abduction to full elevation and then lowered in same motion.
- Positive Test: Pain or pain from 60 to 120 degrees scapular plane abduction
Empty can: SN: .50 (.26–.75) SP: .87 (.77–.98) +LR: 3.90 (1.50–10.12)
- Testing: Shoulder abducted to 90 degrees and slightly adducted. Shoulder internally rotated and downward force applied.
- Positive Test: Pain or inability to maintain abduction.
External rotation resistance: SN: .56 (.32–.81) SP: .87 (.77–.98) +LR: 4.39 (1.74–11.07) .50
- Testing: Elbow flexed to 90 degrees and adducted to trunk with neutral rotation. Medially directed force applied.
- Positive Test: Pain or weakness
Cross-body adduction test: SN: .23 SP: .82
- Testing: Shoulder is elevated to 90 degrees and adducted across body.
- Positive Test: Pain with adduction
Drop arm sign: SN: .27 SP: .88
- Testing: Shoulder is elevated to full flexion and asked to slowly lower.
- Positive Test: Severe pain or inability to slowly lower.
Clusters[edit | edit source]
If three of the following test are positive: Hawkins-Kennedy, neer, painful arc, empty can, and external rotation resistance then SN: .75 (.54–.96) SP: .74 (.61–.88) +LR: 2.93 (1.60–5.36) -LR: .34 (.14–.80)[1]
If Painful arc sign, Drop-arm sign, Infraspinatus muscle test positive the +LR: 15.57 of full thickness rotator cuff tear[2]
If Hawkins-Kennedy impingement sign, Painful arc sign, Infraspinatus muscle test positive then +LR: 10.56 of some type of impingement present[2]
Painful arc, empty can and external rotation resistance are the (2 or more tests are positive) best combination for the diagnosis of Subacromial Impingement Syndrome.[3]
Painful arc and external rotation resistance are the (both tests are negative) best combination for ruling out Subacromial Impingement Syndrome.[3]
References[edit | edit source]
- ↑ 1.0 1.1 Michener LA, Walsworth MK, Doukas WC, Murphy KP. Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. Arch Phys Med Rehabil. 2009 Nov;90(11):1898-903.
- ↑ 2.0 2.1 2.2 Park HB, Yokota A, Gill HS, El Rassi G, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am. 2005 Jul;87(7):1446-55.
- ↑ 3.0 3.1 Chen CW, Pan ZE, Zhang C, Liu CL, Chen L. Zhongguo Gu Shang. 2016;29(5):434-438.