Subacromial Impingement Cluster: Difference between revisions
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== Purpose == | == Purpose == | ||
To test for the presence of subacromial impingement | To test for the presence of subacromial impingement | ||
== Tests for 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> == | ||
'''Hawkins-Kennedy''': SN: .63 (.39–.86) SP: .62 (.46–.77) +LR: 1.63 (.94–2.81) | '''Hawkins-Kennedy''': SN: .63 (.39–.86) SP: .62 (.46–.77) +LR: 1.63 (.94–2.81) | ||
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*Positive Test: Pain or weakness | *Positive Test: Pain or weakness | ||
'''Cross-body adduction test''': SN: .23 SP: .82 | '''Cross-body adduction test''': SN: .23 SP: .82 | ||
*Testing: Shoulder is elevated to 90 degrees and adducted across body. | *Testing: Shoulder is elevated to 90 degrees and adducted across body. | ||
*Positive Test: Pain with adduction | *Positive Test: Pain with adduction | ||
'''Drop arm sign''': SN: .27 SP: .88 | '''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. | ||
*Positive Test: Severe pain or inability to slowly lower. | *Positive Test: Severe pain or inability to slowly lower. | ||
==Clusters== | == Clusters == | ||
If | 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 Painfui 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, Painfui arc sign, Infraspinatus muscle test positive then +LR: 10.56 of some type of impingement present<ref name="Park" /><br> | |||
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | |||
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== References == | |||
References will automatically be added here, see [[Adding References|adding references tutorial]]. | |||
<references /> | |||
[[Category:Articles]] [[Category:Assessment]] [[Category:EIM_Student_Project_2]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Shoulder]] |
Revision as of 14:11, 13 December 2009
Original Editor - Your name will be added here if you created the original content for this page.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Purpose[edit | edit source]
To test for the presence of subacromial impingement
Tests for Subacromial Impingement[1][2][edit | edit source]
Hawkins-Kennedy: SN: .63 (.39–.86) SP: .62 (.46–.77) +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 scaption to full elevation and then lowered in same motion.
- Positive Test: Pain or pain from 60 to 120 degrees scaption
Empty can (Jobe): 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 Painfui 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, Painfui arc sign, Infraspinatus muscle test positive then +LR: 10.56 of some type of impingement present[2]
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ 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.