Champagne Toast Test
Description[edit | edit source]
The Champagne Toast Test or Sign is used to isolate the supraspinatus.
Clinically Relevant Anatomy[edit | edit source]
The supraspinatus muscle belongs to the rotator cuff muscles along with the infraspinatus muscles, subscapularis, teres minor, and the long head of the biceps tendon. It resides in the supraspinous fossa of the scapula, superior to the scapular spine. It participates in shoulder abduction besides being involved in the compression of the humeral head against the glenoid as well as being considered one of the main stabilizers of the glenohumeral joint. Together with the other three rotator cuff muscles, infraspinatus, teres minor, and subscapularis, the supraspinatus forms part of the dynamic stabilization for the glenohumeral joint. The supraspinatus is also involved with the deltoid in both the initiation and the continuation of abduction throughout the range of motion as well as a weak contribution in lateral rotation of the humerus.
Technique[edit | edit source]
- The patient is seated and positions the shoulder in 30° abduction, slight lateral rotation, and 30° forward flexion
- The elbow is in 90° flexion which replicates the position when giving a “ toast”.
- The therapist applies a downward isometric resistance at the elbow.
The test is positive when there is pain or weakness whilst performing the maneuver. It indicates an injury to the supraspinatus muscle.
Evidence[edit | edit source]
Chalmers, et al. in their transitional EMG study, demonstrated that the position that best isolates the abducting activity of the supraspinatus from the abducting activity of the deltoid is 30° shoulder abduction and mild shoulder ER, hence the champagne toast position.
The “champagne toast” sign (30 degrees abduction, external rotation) was found to be 5.75 times better at isolating the supraspinatus compared to the “empty can” test or Jobe’s test. Its clinical use has the potential to improve the sensitivity and specificity of physical examination testing of the supraspinatus.
However, although three published EMG studies have shown that Jobe’s position provides more deltoid than supraspinatus activation; neither position isolated the supraspinatus from the deltoid in their study. Therefore, they also suggested that testing at 30° of abduction in the champagne toast position better isolates the supraspinatus than Jobe’s position does.
References[edit | edit source]
- Redondo-Alonso L, Chamorro-Moriana G, Jiménez-Rejano JJ, López-Tarrida P, Ridao-Fernández C. Relationship between chronic pathologies of the supraspinatus tendon and the long head of the biceps tendon: systematic review. BMC musculoskeletal disorders. 2014 Dec;15(1):1-10.
- Jeno SH, Schindler GS. Anatomy, Shoulder and Upper Limb, Arm Supraspinatus Muscle. StatPearls [Internet]. 2019 Jan 4.
- Young Lae Moon. Shoulder motion with rotator cuff (supraspinatus). Available from: www.youtube.com/watch?v=uskZIqThlb0 [last accessed 7/3/2021]
- David JM, Robert CM ·Medical. Orthopedic Physical Assessment.Musculoskeletal Rehabilitation Series.7th Edition, Elsevier:2020. Chap 5, Pp. 367.
- Cirugia de Hombro y Codo – Guido Fierro MD. Prueba del brindis de Champaña – Champagne toast test. Available from: http://www.youtube.com/watch?v= CCV6wpi2GrU [last accessed 6/3/2021]
- Chalmers PN, Cvetanovich GL, Kupfer N, Wimmer MA, Verma NN, Cole BJ, Romeo AA, Nicholson GP. The champagne toast position isolates the supraspinatus better than the Jobe test: an electromyographic study of shoulder physical examination tests. Journal of shoulder and elbow surgery. 2016 Feb 1;25(2):322-9.
- Denq W. Journal Club: A Toast to a New and Improved Physical Exam Test for the Supraspinatus.