Drop Arm Test
riginal Editor - Beth Reuschel
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Purpose[edit | edit source]
The drop arm test is used to assess for full thickness rotator cuff tears, particularly of the supraspinatus[1]. This can be useful when diagnosing sub-acromial pain syndrome (shoulder impingment) or to differentiate between shoulder and rotator cuff pathologies.
The drop arm test may be more accurate when used in a battery of tests such as empty/full can test, external rotation lag sign and internal rotation lag sign to differentiate between rotator cuff muscles[1].
Technique[edit | edit source]
Stand behind the seated patient and passively abduct the patient's arm to 900 and full external rotation, while supporting the arm at the elbow.
Release the elbow support and ask patient to slowly lower the arm back to neutral.[2]
Instructional video[edit | edit source]
Interpretation[edit | edit source]
The test is negative if the patient is able to control the lowering of the arm slowly and without their symptoms occuring.
It is a positive test if there is a sudden dropping of the arm or weakness in maintaining arm position during the eccentric part of abduction, there may also be pain present while lowering the arm, suggesting a full thickness tear to the supraspinatus.[4][2]
Sensitivity / Specificity[edit | edit source]
Sensitivity of detecting a full thickness supraspinatus tear: 73%[5] and a Specificity of: 77%[5]
- Likelihood Ratio: +LR: 2.79; -LR: .95 [6]
Evidence[edit | edit source]
It was found it is unclear if a full thickness rotator cuff tear can be diagnosed by using any of the cluster of lag signs, let alone solely the drop arm sign[5].
A study of 53 patients suspected to have suffered rotator cuff tears compared physical examination tests to their shoulder MRI and ultrasonography results. The study found that the drop arm test had a 100% PPV and 10% sensitivity.[7]
References[edit | edit source]
- ↑ 1.0 1.1 Sgroi M, Loitsch T, Reichel H, Kappe T. Diagnostic value of clinical tests for supraspinatus tendon tears. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2018 Aug 1;34(8):2326-33.
- ↑ 2.0 2.1 Klaus Buckup. Clinical Tests for the Musculoskeletal System: Examinations - Signs - Phenomena. 2nd ed. Germany: Thieme, 2008
- ↑ Physiotutors. Drop Arm Test/sign | Supraspinatus Tear. Available from: https://www.youtube.com/watch?v=JXgRBeqToik [last accessed 3/7/17]
- ↑ M. Lynn Palmer, Marcia E. Epler, Marcia F. Epler. Fundamentals of Musculoskeletal Assessment Techniques. 2nd ed. Philadelphia: Lippincott Williams & Wilkins, 1998
- ↑ 5.0 5.1 5.2 Miller CA, Forrester GA, Lewis JS. The validity of the lag signs in diagnosing full-thickness tears of the rotator cuff: a preliminary investigation. Archives of physical medicine and rehabilitation. 2008 Jun 1;89(6):1162-8.
- ↑ Calis M, et al. (2000). Diagnostic values of clinical diagnostic tests in subacromial impingement syndrome. Ann Rheum Dis. 59.1. 44-47. Web 10 Dec 2012.
- ↑ Gerard A. Malanga, Scott Nadler. Musculoskeletal Physical Examination: An Evidence-based Approach. Philadelphia: Elsevier Health Sciences, 2006.
