The validity of 9 physical tests for full-thickness rotator cuff tears after primary anterior shoulder dislocation in ED patients

Yuen, Chi Kit; Mok, Ka Leung

doi:10.1016/j.ajem.2011.12.022

Cited by 20 publications

(25 citation statements)

References 26 publications

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“…The significant relation between age and RCT was also reported in many other studies. Yuen et al [13] recorded 37 % incidence of RCT after anterior shoulder dislocation, and all of them were older ladies. Berbig et al [14] reported RCT associated with anterior shoulder dislocation in 32 % of their patients, and all were women above the age of 50 years.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of associated injuries after anterior shoulder dislocation: a prospective study

Atef

El-Tantawy

Gad

et al. 2015

International Orthopaedics (SICOT)

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Section: Discussionmentioning

confidence: 99%

Prevalence of associated injuries after anterior shoulder dislocation: a prospective study

Atef

El-Tantawy

Gad

et al. 2015

International Orthopaedics (SICOT)

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“…This issue was addressed in this study by assessing 15 tests commonly used for the diagnosis of rotator cuff tear and biceps pathology. Prior studies also had limitations such as recruitment from single sites/providers or data obtained by retrospective chart review 27,28,30,32–36 This study addressed these limitations by recruiting from multiple sites and providers, and recruiting patients prospectively. Prior studies have also used either imaging or surgical findings as reference standard for their case definition of a rotator cuff tear 26–28,30–36 .…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies also had limitations such as recruitment from single sites/providers or data obtained by retrospective chart review 27,28,30,32–36 This study addressed these limitations by recruiting from multiple sites and providers, and recruiting patients prospectively. Prior studies have also used either imaging or surgical findings as reference standard for their case definition of a rotator cuff tear 26–28,30–36 . Although MRI/MRA have high sensitivity and specificity for the diagnosis of rotator cuff tear 37–41 , it is well-documented that rotator cuff tears are present even in asymptomatic individuals 19–22 .…”

Section: Discussionmentioning

confidence: 99%

“…In addition we also performed a literature search using the MEDLINE, EMBASE, and CINAHL databases for articles published after February 2012 and until March 2014 on sensitivity, specificity, and accuracy of special tests for rotator cuff tear. This search yielded 3 additional published studies 2627,28 on this topic since the time frame covered by Hegedus articles. A study by Faruqui 29 was excluded because it reported on sensitivity of belly press, lift-off, and bear hug tests combined (and not as individual tests).…”

Section: Methodsmentioning

confidence: 99%

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The Diagnostic Accuracy of Special Tests for Rotator Cuff Tear

Jain

Luz

Higgins

et al. 2017

American Journal of Physical Medicine &Amp; Rehabilitation

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Objective The aim was to assess diagnostic accuracy of 15 shoulder special tests for rotator cuff tears. Design From 02/2011 to 12/2012, 208 participants with shoulder pain were recruited in a cohort study. Results Among tests for supraspinatus tears, Jobe’s test had a sensitivity of 88% (95% CI=80% to 96%), specificity of 62% (95% CI=53% to 71%), and likelihood ratio of 2.30 (95% CI=1.79 to 2.95). The full can test had a sensitivity of 70% (95% CI=59% to 82%) and a specificity of 81% (95% CI=74% to 88%). Among tests for infraspinatus tears, external rotation lag signs at 0° had a specificity of 98% (95% CI=96% to 100%) and a likelihood ratio of 6.06 (95% CI=1.30 to 28.33), and the Hornblower’s sign had a specificity of 96% (95% CI=93% to 100%) and likelihood ratio of 4.81 (95% CI=1.60 to 14.49). Conclusions Jobe’s test and full can test had high sensitivity and specificity for supraspinatus tears and Hornblower’s sign performed well for infraspinatus tears. In general, special tests described for subscapularis tears have high specificity but low sensitivity. These data can be used in clinical practice to diagnose rotator cuff tears and may reduce the reliance on expensive imaging.

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“…All participants underwent a musculoskeletal examination that included special tests for subacromial impingement (painful arc, 24 Neer test, 24,25 infraspinatus test, and Hawkins-Kennedy test 24,26 ), rotator cuff injuries (crossbody adduction, drop-arm test, 27 infraspinatus strength test, 27 and empty-can test 24 ), GH instability (apprehension test, 25 relocation test, 28 anterior release, 28 and sulcus sign), and labral injuries (crank test, 29 anterior slide test, 29 Speed test, 30 biceps load I test, 31 and biceps load II test 30 ). Participants were classified into the GH injury group if they had at least 3 positive special tests for the aforementioned injuries and responded yes to at least 2 of the following 3 questions: (1) Do you experience weakness, throbbing pain, pain with motion, and/or pain with overhead activities?…”

Section: Participantsmentioning

confidence: 99%

Scapular Muscle-Activation Ratios in Patients With Shoulder Injuries During Functional Shoulder Exercises

Moeller

Bliven

Valier

2014

Journal of Athletic Training

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Context: Alterations in scapular muscle activation, which are common with glenohumeral (GH) injuries, affect stability and function. Rehabilitation aims to reestablish activation between muscles for stability by progressing to whole-body movements.Objective Design: Cross-sectional study. Setting: Laboratory.Patients or Other Participants: Thirty-nine participants who had GH injuries (n ¼ 20; age ¼ 23.6 6 3.2 years, height ¼ 170.7 6 11.5 cm, mass ¼ 74.7 6 13.1 kg) or were healthy (n ¼ 19; age ¼ 24.4 6 3.3 years, height ¼ 173.6 6 8.6 cm, mass ¼ 74.7 6 14.8 kg) were tested.Intervention(s): Clinical examination confirmed each participant's classification as GH injury or healthy control. Participants performed 4 exercises (bow and arrow, external rotation with scapular squeeze, lawnmower, robbery) over 3 seconds with no load while muscle activity was recorded.Main Outcome Measure(s): We used surface electromyography to measure UT, MT, LT, and SA muscle activity. Scapular muscle-activation ratios (UT:MT, UT:LT, and UT:SA) were calculated (normalized mean electromyography of the UT divided by normalized mean electromyography of the MT, LT, and SA). Exercise 3 group analyses of variance with repeated measures were conducted.Results: No group differences for activation ratios or individual muscle activation amplitude were found (P . .05). Similar UT:MT and UT:LT activation ratios during bow-andarrow and robbery exercises were seen (P . .05); both had greater activation than external-rotation-with-scapular-squeeze and lawnmower exercises (P , .05). The bow-and-arrow exercise elicited the highest activation from the UT, MT, and LT muscles; SA activation was greatest during the externalrotation-with-scapular-squeeze exercise.Conclusions: Scapular muscle activation was similar between participants with GH injuries and healthy control participants when performing the unloaded multiplanar, multijoint exercises tested. High activation ratios during the bow-andarrow exercise indicate UT hyperactivity or decreased MT, LT, and SA activity. Our GH injury group may be comparable to high-functioning injured athletes. Study results may assist clinicians in selecting appropriate exercises for scapular muscle activation when caring for injured athletes.Key Words: force couple, glenohumeral joint, rehabilitation, serratus anterior muscle, trapezius muscle Key PointsMuscle balance to promote scapular upward rotation, as indicated by muscle-activation ratios, was present and similar between participants with glenohumeral injuries and healthy control participants when performing 4 unloaded multiplanar, multijoint functional exercises. Clinicians should use caution when prescribing the bow-and-arrow exercise because it produced high scapular muscle-activation ratios, indicating upper trapezius hyperactivity and decreased middle trapezius, lower trapezius, and serratus anterior activity. Exercises that promote activation of the middle trapezius, lower trapezius, and serratus anterior muscles while minimizing upper trapezius hyperactivity are ...

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The validity of 9 physical tests for full-thickness rotator cuff tears after primary anterior shoulder dislocation in ED patients

Cited by 20 publications

References 26 publications

Prevalence of associated injuries after anterior shoulder dislocation: a prospective study

Prevalence of associated injuries after anterior shoulder dislocation: a prospective study

The Diagnostic Accuracy of Special Tests for Rotator Cuff Tear

Scapular Muscle-Activation Ratios in Patients With Shoulder Injuries During Functional Shoulder Exercises

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