Empty Can Test: Difference between revisions

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'''Original Editor '''- [[User:Tyler Shultz|Tyler Shultz]]  
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'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}  
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== Purpose<br>  ==


The Empty Can Test is used to assess the supraspinatus muscle and tendon.
== Purpose  ==
The '''Empty Can Test''', also known as the Jobe or Supraspinatus test, is used to assess for lesions of the rotator cuff, specifically the [https://physio-pedia.com/Supraspinatus#share supraspinatus muscle] and [https://physio-pedia.com/Supraspinatus_Tendinopathy#share supraspinatus tendon]. <ref name=":0">Magee D. J. Shoulder. Orthopedic Physical Assessment. 7th Edition. Philadelphia. Elsevier. 2022.</ref>


== Technique ==


# The patients arm is actively abducted to 90<sup>o</sup>
# The examiner applies downward resistance to the abducted arm
# With the patient's hand in a fist, and the thumb sticking out, the shoulder is actively <u>internally rotated</u>, and angled forward to 30<sup>o</sup>, so that their thumb is in a downward facing direction (empty can position), in the scapular plane 


[[Image:Supraspinatus.png|thumb|center|150px|Supraspinatus]]
== Instructional Video ==
Here is a video demonstrating the Empty Can Test:{{#ev:youtube|mC_5Lmy7iAo}}<ref>Clinical Physio. Empty Can Test for Shoulder | Clinical Physio Premium. Available from: https://www.youtube.com/watch?v=mC_5Lmy7iAo&ab_channel=ClinicalPhysio (accessed 17/05/2024). </ref>


<br>
== Interpretation ==
Testing the arm with the thumb in  'thumbs up' (full can position) is most suitable for maximal contraction of the supraspinatus muscle. <ref name=":0" />  


== Technique<ref>Jobe, F.W., Moynes D.R. (1982) Delineation of diagnostic criteria and a rehabilitation program for rotator cuff injuries. American Journal of Sports Medicine. 10, 336-339</ref><br==
Resistance is provided by the examiner, as they are assessing for weakness or pain. Weakness or pain would represent a positive test, which would indicate a tear of the supraspinatus muscle or tendon, or a neuropathy of the suprascapular nerve. <ref name=":0" />   


{| width="40%" cellspacing="1" cellpadding="1" border="0" align="left" class="FCK__ShowTableBorders"
This can also indicate supraspinatus paratenonitis. <ref name=":0" />  
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| align="left" |
| {{#ev:youtube|qjHOqydDhxo|300}}
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| <ref>Online video, http://www.youtube.com/watch?v=qjHOqydDhxo, last accessed 02/03/09</ref>
|}


The patient can be seated or standing for this test. The patient's arm should be elevated to 90 degrees in the scapular plane, with the elbow extended, full internal rotation, and pronation of the forearm. This results in a thumbs-down position, as if the patient were pouring liquid out of a can. The therapist should stabilize the shoulder while applying a downwardly directed force to the arm, the patient tries to resist this motion. This test is considered positive if the patient experiences pain or weakness with resistance. <br> <br> <br> <br> <br> <br> <br>
== Evidence ==
Boettcher CE, et al. demonstrated with normalized EMG that the Empty Can Test activates supraspinatus to levels approximately 90% MVC. Concurrent activation of other shoulder muscles tested including other rotator cuff muscles (infraspinatus and upper subscapularis), scapular positioning muscles (upper, middle and lower trapezius, and serratus anterior), and abduction torque producing muscles (anterior, middle &amp; posterior deltoid) were activated to similarly high levels. <ref>Boettcher CE, Ginn KA, Cathers I. The ‘empty can’ and ‘full can’ tests do not selectively activate supraspinatus. J Sci Med Sport (2008), doi:10.1016/j.jsams.2008.09.005</ref>  


== Evidence  ==
Therefore, the Empty Can Test must be questioned as a valid diagnostic tool for isolated supraspinatus pathology, due to the high activation of many shoulder muscles simultaneously.


Boettcher CE, et al.<ref>Boettcher CE, Ginn KA, Cathers I. The ‘empty can’ and ‘full can’ tests do not selectively activate supraspinatus. J Sci Med Sport (2008), doi:10.1016/j.jsams.2008.09.005</ref> demonstrated with normalised EMG that the Empty Can Test activates supraspinatus to levels approximately 90% MVC. Concurrent activation of other shoulder muscles tested including other rotator cuff muscles (infraspinatus and upper subscapularis), scapular positioning muscles (upper, middle and lower trapezius, and serratus anterior), and abduction torque producing muscles (anterior, middle &amp; posterior deltoid) were activated to similarly high levels.  
The Empty Can Test has a '''specificity''' of 55% for Pain, 68% for muscle weakness, as well as 50% for pain, muscle weakness, or both. <ref name=":0" />       


Therefore, the Empty Can Test must be questioned as a valid diagnostic tool for isolated supraspinatus pathology, due to the high activation of many shoulder muscles simultaneously.  
The Empty Can Test has a '''sensitivity''' of 63% for Pain, 77% for muscle weakness, as well as 89% for pain, muscle weakness, or both. <ref name=":0" />


== Resources  ==
There is a '''positive likelihood ratio''' of 1.40 for pain, 2.41 for muscle weakness, and 1.78 for pain, muscle weakness, or both. <ref name=":0" />


add relevant resources here
There is a '''negative likelihood ratio''' of 0.67 for pain, 0.34 for muscle weakness, and 0.22 for pain, muscle weakness, or both. <ref name=":0" />
<div class="researchbox">
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==


<rss>http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=16IogA8e1N8HKeLC4ZH-UwkwblxyQqPJFHYLle3M7dheG6oAU|charset=UTF-8|short|max=10</rss>
</div>
== References  ==
== References  ==


<references />  
<references />  


  [[Category:Special_Tests]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Shoulder]] [[Category:Videos]]
[[Category:Special_Tests]]  
[[Category:Shoulder]]
[[Category:Shoulder - Special Tests]]
[[Category:Shoulder - Assessment and Examination]]
[[Category:Musculoskeletal/Orthopaedics]]  
[[Category:Primary Contact]]
[[Category:Sports Medicine]]
[[Category:Athlete Assessment]]
[[Category:Assessment]]

Latest revision as of 20:51, 25 May 2024

Purpose[edit | edit source]

The Empty Can Test, also known as the Jobe or Supraspinatus test, is used to assess for lesions of the rotator cuff, specifically the supraspinatus muscle and supraspinatus tendon. [1]

Technique[edit | edit source]

  1. The patients arm is actively abducted to 90o
  2. The examiner applies downward resistance to the abducted arm
  3. With the patient's hand in a fist, and the thumb sticking out, the shoulder is actively internally rotated, and angled forward to 30o, so that their thumb is in a downward facing direction (empty can position), in the scapular plane

Instructional Video[edit | edit source]

Here is a video demonstrating the Empty Can Test:

[2]

Interpretation[edit | edit source]

Testing the arm with the thumb in 'thumbs up' (full can position) is most suitable for maximal contraction of the supraspinatus muscle. [1]

Resistance is provided by the examiner, as they are assessing for weakness or pain. Weakness or pain would represent a positive test, which would indicate a tear of the supraspinatus muscle or tendon, or a neuropathy of the suprascapular nerve. [1]

This can also indicate supraspinatus paratenonitis. [1]

Evidence[edit | edit source]

Boettcher CE, et al. demonstrated with normalized EMG that the Empty Can Test activates supraspinatus to levels approximately 90% MVC. Concurrent activation of other shoulder muscles tested including other rotator cuff muscles (infraspinatus and upper subscapularis), scapular positioning muscles (upper, middle and lower trapezius, and serratus anterior), and abduction torque producing muscles (anterior, middle & posterior deltoid) were activated to similarly high levels. [3]

Therefore, the Empty Can Test must be questioned as a valid diagnostic tool for isolated supraspinatus pathology, due to the high activation of many shoulder muscles simultaneously.

The Empty Can Test has a specificity of 55% for Pain, 68% for muscle weakness, as well as 50% for pain, muscle weakness, or both. [1]

The Empty Can Test has a sensitivity of 63% for Pain, 77% for muscle weakness, as well as 89% for pain, muscle weakness, or both. [1]

There is a positive likelihood ratio of 1.40 for pain, 2.41 for muscle weakness, and 1.78 for pain, muscle weakness, or both. [1]

There is a negative likelihood ratio of 0.67 for pain, 0.34 for muscle weakness, and 0.22 for pain, muscle weakness, or both. [1]

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Magee D. J. Shoulder. Orthopedic Physical Assessment. 7th Edition. Philadelphia. Elsevier. 2022.
  2. Clinical Physio. Empty Can Test for Shoulder | Clinical Physio Premium. Available from: https://www.youtube.com/watch?v=mC_5Lmy7iAo&ab_channel=ClinicalPhysio (accessed 17/05/2024).
  3. Boettcher CE, Ginn KA, Cathers I. The ‘empty can’ and ‘full can’ tests do not selectively activate supraspinatus. J Sci Med Sport (2008), doi:10.1016/j.jsams.2008.09.005