Diagnostic Accuracy of Clinical Tests for the Different Degrees of Subacromial Impingement Syndrome

Park, Hyung Bin; Yokota, Atsushi; Gill, Harpreet; Rassi, George El; McFarland, Edward G.

doi:10.2106/00004623-200507000-00005

Cited by 92 publications

(136 citation statements)

References 18 publications

Supporting

Mentioning

119

Contrasting

Unclassified

Order By: Relevance

“…The examination included active and passive ROM, manual muscle strength testing, an upper extremity neurologic evaluation, and determination of other physical examination signs, including the Neer impingement sign [13,18,27,31,32], Kennedy-Hawkins impingement sign [17,18,27,29,31,32], and Gagey sign [12] (suggested as a measure of inferior capsular contracture). Weakness in abduction or external rotation with the arm at the side had been recorded.…”

Section: Methodsmentioning

confidence: 99%

“…To determine the relationship of weakness to a positive shrug sign, patients with a strength grade of 4 or less in abduction or in external rotation with the arm at the side was the independent variable and patients with normal abduction strength (ie, Grade 5) comprised the control group. A third variable studied for weakness was the ''drop arm sign''; the inability to hold the arm against gravity when it was placed above 90°elevation was considered a positive sign [7,31]. We tested the association between these three binary outcomes and the shrug sign using a chi square test of independence with one degree of freedom.…”

Section: Methodsmentioning

confidence: 99%

“…Examining patients with shoulder problems can be challenging because (1) shoulder motion involves a complex interaction of movement of the scapula on the thorax, the humeral head on the glenoid, and the clavicle at the acromioclavicular and sternoclavicular joints [6,13,24]; and (2) physical examination tests for the shoulder are sensitive but not specific for one particular shoulder condition [4,5,10,20,23,26,[29][30][31]. It is important clinicians understand the limitations of physical examination tests when evaluating patients with shoulder pain.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Evaluation of the Shoulder Shrug Sign

Jia

Petersen

et al. 2008

Clinical Orthopaedics &Amp; Related Research

Self Cite

View full text Add to dashboard Cite

The ''shrug sign'' (inability to lift the arm to 90°abduction without elevating the whole scapula or shoulder girdle) has been associated with a diagnosis of rotator cuff disease. Based on our clinical experience, we hypothesized the shrug sign is not a specific diagnostic sign for this condition, but rather is associated with various shoulder conditions and shoulder weakness and loss of range of motion. We retrospectively reviewed 982 consecutive patients who had been examined preoperatively for the shrug sign. A positive shrug sign was present in 51.3% of the patients, and the average distance lost from the horizontal was 20.5°± 2.2°(standard error of mean). Increasing age was associated with the presence of a shrug sign. The highest incidence was in patients with adhesive capsulitis (94.7%). The shrug sign was not sensitive for tendinosis, partial rotator cuff tears, or full-thickness or massive rotator cuff tears. The shrug sign was associated with weakness in abduction, night pain, and loss of range of motion, especially passive abduction. Although the shrug sign is useful as a general sign of shoulder abnormality, particularly when associated with stiffness, it was not specific or sensitive for rotator cuff problems.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Evaluation of the Shoulder Shrug Sign

Jia

Petersen

et al. 2008

Clinical Orthopaedics &Amp; Related Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…• a minimum of three positive orthopaedic special tests (Michener, Walsworth, Doukas, & Murphy, 2009;Park, Yokota, Gill, Rassi, & McFarland, 2005). …”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

“…Hawkins-Kennedy (Hawkins & Kennedy, 1980) and/or Neer (Neer, 1983) must be positive along with two of the following: external rotation resistance test (Michener et al, 2009),tendon palpation (N. Hanchard et al, 2004), horizontal (cross-body) adduction (Park et al, 2005), painful arc (Kessel & Watson, 1977), drop arm test (Park et al, 2005), Yergason test (Dalton, 1989), Speed test (Dalton, 1989;Park et al, 2005) • 'catching' or aching pain without appreciable joint stiffness (N. C. A. Hanchard & Handoll, 2008) • a painful arc elicited with pain easing on lowering the arm (N. Hanchard et al, 2004) • pain localized to the anterior or antero-lateral-superior shoulder (J. S. Lewis et al, 2001) • insidious onset of symptoms with a possible history of gradual progression over time but without history of trauma (Bigliani & Levine, 1997) • xray or ultrasound scans revealing osteophytes within the subacromial region, calcification of tendons or large rotator cuff tears .…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement

Land

Gordon

Watt

2017

Musculoskeletal Science and Practice

View full text Add to dashboard Cite

Background: Current conservative management of subacromial shoulder impingement (SSI) includes generic strengthening exercises, especially for internal (IR) and external (ER) shoulder rotators. However, there is no evidence that the strength or the ratio of strength between these muscle groups is different between those with SSI (cases) and an asymptomatic population (controls).Objective: To identify if isokinetic rotator cuff strength or the ratio of strength is significantly different between cases and controls.Study Design: Case Control Study.Method: Fifty one cases with SSI and 51 asymptomatic controls matched for age, gender, hand dominance and physical activity level completed isokinetic peak torque glenohumeral IR and ER testing. Within the SSI group, 31 dominant limbs were symptomatic and 20 non-dominant limbs were symptomatic. IR and ER were measured separately using continuous reciprocal concentric (con) and eccentric (ecc) contraction cycles at a speed of 60 0 degrees per second and again at 120 0 degrees per second. Values of peak torque (PT), relative peak torque (RPT) and ratios were compared using independent t-tests between the SSI and asymptomatic groups.Results: Significant strength differences between the two groups were present only when the symptomatic SSI shoulder was the dominant shoulder (con ER PT at 60 0 /second, ecc ER PT at 120 0 /second, ecc ER RPT at 120 0 /second and ecc IR PT at 60 0 /second and 120 0 /second). Conclusions:Changes in rotator cuff strength in SSI may be related to limb dominance, which may have implications for strengthening regimes. Level of Evidence:Level 3a

show abstract

The influence of exercise on clinical pain and pain mechanisms in patients with subacromial pain syndrome

Lyng

Andersen

Jensen

et al. 2022

European Journal of Pain

View full text Add to dashboard Cite

Background Few studies have investigated the underlying mechanisms for unilateral subacromial pain syndrome (SAPS). Therefore, this study examined (1) if 8‐weeks of exercise could modulate clinical pain or temporal summation of pain (TSP), conditioned pain modulation (CPM), and exercise‐induced hypoalgesia (EIH) and (2) if any of these parameters could predict the effect of 8‐weeks of exercise in patients with unilateral SAPS. Methods Thirty‐seven patients completed a progressive abduction exercise program every other day for 8‐weeks. Worst shoulder pain in full abduction was rated on a numeric rating scale (NRS). Pain pressure thresholds (PPTs), TSP, CPM, EIH, Shoulder Pain and Disability Index (SPADI), Pain Catastrophizing Scale (PCS), PainDETECT questionnaire (PD‐Q), Pain Self‐Efficacy Questionnaire (PSE‐Q) and Pittsburgh Sleep Quality Index (PSQI) were assessed before and after intervention. Results The intervention improved worst pain intensity (p < 0.001), increased the CPM (p < 0.001), improved the sleep scores (p < 0.005) and reduced the PainDETECT ratings (p < 0.001). No changes were observed in PPT, TSP, EIH, SPADI, PCS and PSE‐Q (all p > 0.05). In a linear regression, the combination of all baseline parameters predicted 23.2% variance in absolute change in pain after 8 weeks. Applying backwards elimination to the linear regression yielded that baseline pain intensity combined with TSP predicted 33.8% variance. Conclusion This explorative study suggested reduction in pain, improved sleep quality and increased CPM after 8‐weeks of exercise. Furthermore, the results suggests that low pain intensity and high TSP scores (indicative for pain sensitisation) may predict a lack of pain improvement after exercise.

show abstract

Diagnostic Accuracy of Clinical Tests for the Different Degrees of Subacromial Impingement Syndrome

Cited by 92 publications

References 18 publications

Clinical Evaluation of the Shoulder Shrug Sign

Clinical Evaluation of the Shoulder Shrug Sign

Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement

The influence of exercise on clinical pain and pain mechanisms in patients with subacromial pain syndrome

Contact Info

Product

Resources

About