Resisted AC Joint Extension Test

Purpose

Resisted AC Joint Extension Test (or the AC Resisted Extension Test) is used to help identify acromioclavicular joint pathology in both traumatic and non-traumatic/chronic overuse cases,[1] and can be useful in helping differentiate between AC joint and impingement syndromes.[2]

Technique[3]

  1. The patient is seated with the therapist standing behind him/her
  2. The patient's shoulder is positioned into 90 flexion and internal rotation, with the placed into 90 flexion
  3. The therapist places his/her hand on the patient's elbow and asks him/her to horizontally abduct the arm against isometric resistance
  4. A positive test is pain at the AC joint
[4]

Evidence[5]

Diagnostic Test Properties for the Resisted AC Joint Extension Test
Sensitivity (%)         72
Specificity (%)         85
Positive Predictive Value (%)         20
Negative Predictive Value (%)         98


Test Item Cluster:
This test can be combined with the Cross Body Adduction Test and O'Brien's Active Compression Test as part of a cluster.

Diagnostic Value of Combined Physical Tests
Sensitivity (%) Specificity (%) Positive Predictive Value (%) Negative Predictive Value (%)
Positive in 3/3           25           97                       31                       96
Positive in 2/3           81           89                       28                       99
Positive in 1/3            0           74                       17                      100

References

  1. Miller MD & Thompson SR. DeLee & Drez's Orthopaedic Sports Medicine (4th Ed). Philadelphia, PA: Elsevier.
  2. Frontera WR, Silver JK, Rizzo TD (Jr). Essentials of Physical Medicine and Rehabilitation (3rd Ed). Philadelphia, PA: Elsevier.
  3. Cook CE & Hegedus EJ. Orthopedic Physical Examination Tests: An Evidence-Based Approach (2nd Ed). Boston, MA: Pearson.
  4. Resisted AC Joint Extension Test from https://www.youtube.com/watch?v=YHdZQnV0KhU. Last accessed April 1, 2016.
  5. Chronopoulos E1, Kim TK, Park HB, Ashenbrenner D, McFarland EG. Diagnostic value of physical tests for isolated chronic acromioclavicular lesions. Am J Sports Med, 2004; 32(3): 655-61.