Diagnostic values of clinical diagnostic tests in subacromial impingement syndrome

Çalış, Mustafa; Akgün, Kenan; Birtane, Murat; Karacan, İlhan; Çalış, Havva Talay; Tüzün, Fikret

doi:10.1136/ard.59.1.44

Cited by 284 publications

(174 citation statements)

References 15 publications

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“…We chose a homogeneous group for the assessments (Table 1), and all the athletes participated in similar categories. The only difference between the groups was the presence or the absence of pain during the tennis matches and during the irritative tests 18,19,20 that were performed by the first evaluator. In this context, we observed an average of 45 mm on the VAS in the dominant shoulder, which is more than the minimal clinically important difference in patients with shoulder disorders 28 .…”

Section: Discussionmentioning

confidence: 99%

“…They also could not report feeling pain in the following shoulder tests: Hawkins-Kennedy 18 , O'Brien 19 , and Shoulder Internal Impingement 20 . On the other hand, the subjects included in the PG all complained of dominant shoulder pain during and after the matches and also were required to have positive signs in the shoulder tests described above.…”

Section: Methods Subjectsmentioning

confidence: 99%

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Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players

Marcondes¹,

Jesus²,

Bryk³

et al. 2013

Braz. J. Phys. Ther.

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| Background: Previous studies have shown a relationship between shoulder posterior capsule tightness and shoulder pain in overhead athletes. However, this relationship has not been studied in tennis players. Objectives: Assessment of the shoulder range of motion (ROM), strength and posterior capsule tightness of skilled amateur tennis players who had complaints of dominant shoulder pain in comparison with tennis players without pain. Method: Fortynine skilled amateur tennis players were distributed in 2 groups: Control Group (n=22) and Painful Group (n=27). The first group was composed of asymptomatic subjects, and the second was composed of subjects with shoulder pain on the dominant side. These groups were evaluated to determine the dominant and non-dominant shoulder ROM (internal and external rotation), isometric shoulder strength (internal and external rotation) and posterior shoulder tightness by blind evaluators. Results: The ANOVA results indicated significant differences between the groups in the dominant shoulder ROM, posterior capsule tightness, external rotation strength and strength ratio (p<0.05). The intragroup analysis (dominant versus non-dominant) in the Painful Group displayed a significant difference for ROM, posterior capsule tightness and external rotation strength (p<0.05). Conclusions: The tennis players with pain in the dominant shoulder presented greater posterior capsule tightness, internal rotation deficit (ROM), external rotation gain (ROM) and deficits in external rotation strength than the tennis players without pain.Keywords:physical therapy; rehabilitation; tennis; rotator cuff; Shoulder Impingement Syndrome. HOW TO CITE THIS ARTICLEMarcondes FB, Jesus JF, Bryk FF, Vasconcelos RA, Fukuda TY. Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players. Braz J Phys Ther.

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Section: Discussionmentioning

confidence: 99%

Section: Methods Subjectsmentioning

confidence: 99%

Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players

Marcondes¹,

Jesus²,

Bryk³

et al. 2013

Braz. J. Phys. Ther.

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“…These findings support previous reports of improved accuracy for rotator cuff pathology using combinations of clinical tests. 28,30,31,42 The majority of previous diagnostic accuracy studies in this area involved patients recruited primarily from surgical waiting lists and investigated only a small number of predominantly physical examination tests, reporting variable accuracy findings. 26,29,32,38,64 Only a limited number of studies estimated the diagnostic accuracy of patient history variables for identifying rotator cuff tears.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of clinical examination features for identifying large rotator cuff tears in primary health care

Cadogan

McNair

Laslett

et al. 2013

Journal of Manual & Manipulative Therapy

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Objectives: Rotator cuff tears are a common and disabling complaint. The early diagnosis of medium and large size rotator cuff tears can enhance the prognosis of the patient. The aim of this study was to identify clinical features with the strongest ability to accurately predict the presence of a medium, large or multitendon (MLM) rotator cuff tear in a primary care cohort. Methods: Participants were consecutively recruited from primary health care practices (n5203). All participants underwent a standardized history and physical examination, followed by a standardized X-ray series and diagnostic ultrasound scan. Clinical features associated with the presence of a MLM rotator cuff tear were identified (P,0.200), a logistic multiple regression model was derived for identifying a MLM rotator cuff tear and thereafter diagnostic accuracy was calculated. Results: A MLM rotator cuff tear was identified in 24 participants (11.8%). Constant pain and a painful arc in abduction were the strongest predictors of a MLM tear (adjusted odds ratio 3.04 and 13.97 respectively). Combinations of ten history and physical examination variables demonstrated highest levels of sensitivity when five or fewer were positive [100%, 95% confidence interval (CI): 0.86-1.00; negative likelihood ratio: 0.00, 95% CI: 0.00-0.28], and highest specificity when eight or more were positive (0.91, 95% CI: 0.86-0.95; positive likelihood ratio 4.66, 95% CI: 2.34-8.74). Discussion: Combinations of patient history and physical examination findings were able to accurately detect the presence of a MLM rotator cuff tear. These findings may aid the primary care clinician in more efficient and accurate identification of rotator cuff tears that may require further investigation or orthopedic consultation.

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“…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%

Clinical Evaluation of the Shoulder Shrug Sign

Jia

Petersen

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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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.

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Diagnostic values of clinical diagnostic tests in subacromial impingement syndrome

Cited by 284 publications

References 15 publications

Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players

Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players

Diagnostic accuracy of clinical examination features for identifying large rotator cuff tears in primary health care

Clinical Evaluation of the Shoulder Shrug Sign

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