Yocum's Test

Original Editor - Anas Mohamed Top Contributors - Anas Mohamed and Amanda Ager

Purpose

The Yocum's Test is used to examine the possibility of a shoulder rotator cuff impingement (subacromial impingement syndrome).

It is also referred to as the Yocum Maneuvre.

Technique

During the Yocum Test / Manoeuvre, the arm is forced to ADDuction and the elbow is flexed until the hand is over the contralateral shoulder. Then the patient raises the elbow without moving the shoulder. The test is considered to be positive if the patient has pain during the manoeuvre.[1]

Step 1 Ask the patient to place the hand of their affected shoulder, to the opposite shoulder (cross body ADDuction).

Step 2 The examiner will then elevate the elbow.

Step 3 If the patient experiences pain or demonstrates signs of apprehension, the test is considered positive.

[2]


Evidence

Table 1: PE findings in MRI-confirmed Subacromial impingement syndrome (Silva et al. 2008)[3]

MRI
+ S (%) Sp (%) PPV (%) NPV (%) Accuracy (%) LR (95% CI)
Neer + 13 7 68.4 30.0 65.0 33.3 55.2 0.98 (0.59, 1.62)
6 3
Hawkins + 14 6 73.7 40.0 70.0 44.4 62.1 1.23 (0.69, 2.18)
5 4
Yocum + 15 6 79.0 40.0 71.4 50.0 65.5 1.32 (0.75, 2.30)
4 4
Jobe + 14 7 73.7 30.0 66.7 37.5 58.6 1.05 (0.65, 1.71)
5 3
Patte + 11 4 57.9 60.0 73.3 42.9 58.6 1.45 (0.62, 3.39)
8 6
Gerber + 13 5 68.4 50.0 72.2 45.5 62.1 1.37 (0.69, 2.73)
6 5
Passive ABD + 14 9 73.7 10.0 60.9 16.7 51.7 0.82 (0.58, 1.15)
5 1
Resisted ABD + 11 8 57.9 20.0 57.9 20.0 44.8 0.72 (0.44, 1.18)
8 2

S(%)=sensitivity, Sp(%)=specificity, PPV=positive predictive values, NPV=negative predictive values, LR= likelihood ratio (LR = sensitivity/1−specificity)

Yocum's Test has a good level of sensitivity (79%) and specificity (40%) for SIS.[4]

References

  1. David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
  1. Yocum LA. Assessing the shoulder. History, physical examination, differential diagnosis, and special tests used, Clin Sports Med, 1983, vol. 2 (pg. 281-9).
  2. Yocum’s Test - Shoulder impingement Assessment: https://youtu.be/i39VxR1NeSE
  3. L. Silva, J. L. Andréu, P. Muñoz, M. Pastrana, I. Millán, J. Sanz, C. Barbadillo, M. Fernández-Castro, Accuracy of physical examination in subacromial impingement syndrome, Rheumatology, Volume 47, Issue 5, May 2008, Pages 679–683, https://doi.org/10.1093/rheumatology/ken101
  4. Silva L, Andréu JL, Muñoz P, et al. Accuracy of physical examination in subacromial impingement syndrome. Rheumatology (Oxford). 2008;47(5):679-683. doi:10.1093/rheumatology/ken101