Inverted Supinator Test: Difference between revisions

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== Purpose  ==
== Purpose  ==



Revision as of 09:52, 26 February 2021

Original Editor - User Name
Top Contributors - Vidya Acharya, Manisha Shrestha and Amanda Ager

This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (26/02/2021)

Purpose[edit | edit source]

The inverted supinator (brachioradialis) test is used for identifying a lesion at the C5-C6 spinal cord segments. The inverted supinator reflex is a test that was introduced into clinical medicine by Babinski (1910). [1]

There are two components of this abnormal reflex:

  • an absence of contraction of the brachioradialis muscle when the styloid process of the radius is tapped, and
  • a hyperactive response of the finger flexor muscles; a response that is subserved by a lower spinal cord segment (C8).

Technique[edit | edit source]

Normal response is wrist pronation and/or elbow flexion.

Positive test involves finger flexion and/or elbow extension [2]

Evidence[edit | edit source]

The test has demonstrated a sensitivity of 61% and a specificity of 78% [2]

Research study aimed at producing a cluster of predictive clinical test findings for a sample of a patient using a clinical diagnosis as the reference standard for CSM found that selected combinations of clinical findings: (1) gait deviation; (2) +Hoffmann’s test; (3) inverted supinator sign (sensitivity 0.18; specificity:0.99; +LR 29.1;-LR:0.82); (4) +Babinski test; and (5) age >45 years were effective in ruling out and ruling in cervical spine myelopathy. Combinations of three of five or four of five tests enabled adjustments of post-test probability of the condition to 94–99% and these clusters may be useful in identifying patients with this complex diagnosis in similar patient populations.[3]

[4]

Resources[edit | edit source]

add any relevant resources here

References[edit | edit source]

  1. Estanol BV, Marin OS. Mechanism of the inverted supinator reflex. A clinical and neurophysiological study. Journal of Neurology, Neurosurgery & Psychiatry. 1976 Sep 1;39(9):905-8.
  2. 2.0 2.1 Neck and Arm Pain Syndromes E-Book: Evidence-informed Screening, Diagnosis. Cesar Fernandez de las Penas, Joshua Cleland, Peter A. Huijbregts
  3. Cook C, Brown C, Isaacs R, Roman M, Davis S, Richardson W. Clustered clinical findings for diagnosis of cervical spine myelopathy. Journal of Manual & Manipulative Therapy. 2010 Dec 1;18(4):175-80.
  4. Physiotutors Inverted Supinator Sign | Upper Motor Neuron Lesion. Available from https://www.youtube.com/watch?v=_H5Pv8istcI&vl=es. Accessed on 25/2/21