Resisted AC Joint Extension Test

Original Editor - Evan Thomas

Lead Editors - Evan Thomas, Kai A. Sigel, Naomi O'Reilly and Wanda van Niekerk

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.

[6]
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

Resources

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. Physiotutors. Cross Body Adduction Test | Acromioclavicular Joint Pathology. Available from: https://www.youtube.com/watch?v=DKLvt816x6o
  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.
  6. Physiotutors. AC Joint Provocation Cluster | Acromioclavicular Joint Pathology. Available from: https://www.youtube.com/watch?v=npHPXrV6_JI