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Clinical Tests for Shoulder

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Clinical Tests for Shoulder
Shoulder Examination TestsShoulder Examination Tests
Anterior Apprehension TestAnterior Apprehension Test
Anterior Drawer TestAnterior Drawer Test
Biceps Load TestBiceps Load Test
Biceps Load Test 2Biceps Load Test 2
Empty Can/Full Can TestEmpty Can/Full Can Test
Hawkins-Kennedy TestHawkins-Kennedy Test
Inferior Sulcus TestInferior Sulcus Test
Jobe Relocation TestJobe Relocation Test
Lift-Off TestLift-Off Test
Load & Shift TestLoad & Shift Test
Neer Impingement SignNeer Impingement Sign
OBriens TestOBriens Test
Pain Provocation TestPain Provocation Test
Posterior Drawer TestPosterior Drawer Test
SLAPprehension TestSLAPprehension Test
Speeds TestSpeeds Test
Yergasons TestYergasons Test
The Shoulder Symptom Modification Procedure (SSMP)The Shoulder Symptom Modification Procedure (SSMP)



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Empty Can/Full Can Test

Jo Gibson, 2005

The Empty Can Test (ECT) was originally described by Jobe and Moynes to test integrity of the supraspinatus tendon. Kelly later proposed the Full Can Test (FCT) as an alternative as though EMG activity in the supraspinatus was similar in both positions the FCT was less provocative. It was therefore less likely to result in muscle weakness due to pain provocation.

Test

The patient is tested at 90° elevation in the scapula plane and full internal rotation (empty can) or 45°external rotation (full can). Patient resists downward pressure exerted by examiner at patients elbow or wrist.

click for video

Positive

FCT

  • Pain
  • Muscle weakness Pain/Muscle Weakness/Both

ECT

  • Pain
  • Muscle weakness Pain/Muscle Weakness/Both
  • Pain located to subacromial region and/or weakness.

Research

In Itoi's study the two tests were performed in 143 shoulders of 136 consecutive patients. The tests were considered positive when there was pain, muscle weakness or both. Shoulders were then examined by high resolution MRI with 95% accuracy for full thickness tears of the supraspinatus tendon. There were 35 shoulders with full thickness tear of the supraspinatus tendon. The accuracy of the tests was the greatest when muscle weakness was interpreted as indicating a tom supraspinatus tendon in both the full can test (75% accurate) and the empty can test (70%) accurate).
Itoi suggests that as the empty can position is more likely to be pain provoking, the full can test may be more beneficial in the clinical setting.

Sensitivity   Specificity   Accuracy
66%    64%    64%
77%    74%    75%
86%    57%    64%
63%    77%    89%
55%    68%    50%
57%    57%    59%

Kelly, Kadrmas & Speer (1996) showed the best position for maximal isolation of the supraspinatus muscle was best achieved with the test position of elevation at 90° of scapular elevation and +45° (external rotation) of humeral rotation ('full can'). Howver, Boettcher, Ginn & Carruthers (2009) demonstrated on EMG studies that the supraspinatus is not sufficiently isolated in the empty can postion of abduction, calling into question the validity of this test for the diagnosis of suprapinatus patholgy.

a structure (tissue) that attaches a muscle to a bone. When a tendon becomes inflamed, the condition is referred to as tendinitis or tendonitis.
Top muscle and tendon of the rotator cuff. Abducts the arm. It is the tendon that is most often torn.
moving of a body part away from the central axis of the body


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