Subacromial Impingement Cluster

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目的[edit|edit source]

To test for the presence of subacromial impingement

Tests for Subacromial Impingement[1][2][edit|edit source]

Hawkins-Kennedy: SN: .63 (.39–.86) SP: .62 (.46–.77) +LR: 1.63 (.94–2.81)

  • Testing: Shoulder is flexed to 90 degrees and then internally rotated with elbow flexed to 90 degrees.
  • Positive Test: Pain with IR.

Neer: SN: .81 (.62–1.0) SP: .54 (.38–.69) +LR: 1.76 (1.17–2.66)

  • Testing: Examiner stablizers scapula and flexes shoulder until pain is felt or end of ROM.
  • Positive Test: Pain with flexion

Painful arc: SN: .75 (.54–.96) SP: .67 (.52–.81) +LR: 2.25 (1.33–3.81)

  • Testing: Shoulder is elevated in scapular plane abduction to full elevation and then lowered in same motion.
  • Positive Test: Pain or pain from 60 to 120 degrees scapular plane abduction

Empty can (Jobe):SN: .50 (.26–.75) SP: .87 (.77–.98) +LR: 3.90 (1.50–10.12)

  • Testing: Shoulder abducted to 90 degrees and slightly adducted. Shoulder internally rotated and downward force applied.
  • Positive Test: Pain or inability to maintain abduction.

外部旋转阻力:SN: .56 (.32–.81) SP: .87 (.77–.98) +LR: 4.39 (1.74–11.07) .50

  • Testing: Elbow flexed to 90 degrees and adducted to trunk with neutral rotation. Medially directed force applied.
  • Positive Test: Pain or weakness

Cross-body adduction test: SN: .23 SP: .82

  • Testing: Shoulder is elevated to 90 degrees and adducted across body.
  • Positive Test: Pain with adduction

Drop arm sign: SN: .27 SP: .88

  • Testing: Shoulder is elevated to full flexion and asked to slowly lower.
  • Positive Test: Severe pain or inability to slowly lower.

Clusters[edit|edit source]

[3]

If three of the following test are positive: Hawkins-Kennedy, neer, painful arc, empty can, and external rotation resistance then SN: .75 (.54–.96) SP: .74 (.61–.88) +LR: 2.93 (1.60–5.36) -LR: .34 (.14–.80)[1]

If Painfui arc sign, Drop-arm sign, Infraspinatus muscle test positive the +LR: 15.57 of full thickness rotator cuff tear[2]

If Hawkins-Kennedy impingement sign, Painfui arc sign, Infraspinatus muscle test positive then +LR: 10.56 of some type of impingement present[2]

Recent Related Research (fromPubmed)[edit|edit source]

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References[edit|edit source]

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  1. 1.01.1Michener LA, Walsworth MK, Doukas WC, Murphy KP. Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. Arch Phys Med Rehabil. 2009 Nov;90(11):1898-903.
  2. 2.02.12.2Park HB, Yokota A, Gill HS, El Rassi G, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am. 2005 Jul;87(7):1446-55.
  3. Physiotutors. Subacromial Pain Syndrome Cluster | SAPS. Available from:https://www.youtube.com/watch?v=UErH4NUsDWQ