Full Can Test: Difference between revisions
No edit summary |
No edit summary |
||
| Line 2: | Line 2: | ||
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div> | '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div> | ||
== Purpose == | == Purpose == | ||
The Full Can Test is used to assess the function of the [[Supraspinatus]] muscle and tendon of the shoulder complex. <br> | |||
The Full Can Test is used to assess the function of [[Supraspinatus]] muscle and tendon of the shoulder complex. <br> | |||
== Technique == | == Technique == | ||
[[File:Supraspinatus muscle.png|thumb|244x244px]]The patient can be seated or standing for this test, holding their arm at 90° of elevation in the scapular plane (30° anterior to the frontal plane) with full external rotation of the glenohumeral joint. In this position, the patient's thumb should be pointing up. The therapist should stabilize the shoulder while applying a downward force to the arm whilst the patient tries to resist this motion. | |||
There is no firm consensus on the result of this test, some studies have indicated that a positive full can test is indicated by shoulder pain and/ or shoulder elevation weakness and is suggestive of rotator cuff disease <ref name=":0">Sgroi M, Loitsch T, Reichel H, Kappe T. Diagnostic Value of Clinical Tests for Supraspinatus Tendon Tears. Arthroscopy. [https://www-clinicalkey-com-au.ezproxy.library.uq.edu.au/#!/content/playContent/1-s2.0-S0749806318302755?returnurl=null&referrer=null 2018;34(8):2326–33.] </ref><ref>Timmons MK, Yesilyaprak SS, Ericksen J, Michener LA. Full can test: Mechanisms of a positive test in patients with shoulder pain. Clin Biomech [Internet]. 2017;42:9–13. </ref>. | |||
However, an RCT suggests that weakness should be considered the gold standard during interpretation of the test results, due to higher diagnostic accuracy and correlation with arthroscopic findings<ref name=":0" />. | |||
{{#ev:youtube|SGEIKmiP09s|300}}<ref>Ccedseminars. Full Can Test. Available from: https://www.youtube.com/watch?v=SGEIKmiP09s [last accessed 1/7/2024]</ref> | {{#ev:youtube|SGEIKmiP09s|300}}<ref>Ccedseminars. Full Can Test. Available from: https://www.youtube.com/watch?v=SGEIKmiP09s [last accessed 1/7/2024]</ref> | ||
| Line 15: | Line 15: | ||
== Evidence == | == Evidence == | ||
Kelly et al. reported that the full-can test for assessment of supraspinatus function | Kelly et al. reported that the full-can test for assessment of supraspinatus function had similar electromyographic (EMG) activity compared with the [[Empty Can Test]], but that it provoked less pain. Their findings showed no significant difference in supraspinatus muscle activation with variation in humeral rotation. There is slightly less activation of the [[infraspinatus]] muscle leading to a better isolation of the muscle. <ref>Kelly BT, Kadrmas WR, Speer KP. The manual muscle examination for rotator cuff strength: an electromyographic investigation. The American journal of sports medicine. 1996 Sep;24(5):581-8.</ref> It is also suggested that in this testing position, there is less activity of surrounding muscles such as [[deltoid]] and [[subscapularis]].<ref>Lee CK, Itoi E, Kim SJ, Lee SC, Suh KT. Comparison of muscle activity in the empty-can and full-can testing positions using 18 F-FDG PET/CT. Journal of orthopaedic surgery and research. 2014 Dec;9(1):1-8.</ref> | ||
The Full Can Test had a sensitivity of 70% (95% CI=59% to 82%) and a specificity of 81% (95% CI=74% to 88%)<ref>Jain NB, Luz J, Higgins LD, Dong Y, Warner JJ, Matzkin E, Katz JN. The diagnostic accuracy of special tests for rotator cuff tear: the ROW cohort study. American journal of physical medicine & rehabilitation. 2017 Mar;96(3):176.</ref>. | The Full Can Test had a sensitivity of 70% (95% CI=59% to 82%) and a specificity of 81% (95% CI=74% to 88%)<ref>Jain NB, Luz J, Higgins LD, Dong Y, Warner JJ, Matzkin E, Katz JN. The diagnostic accuracy of special tests for rotator cuff tear: the ROW cohort study. American journal of physical medicine & rehabilitation. 2017 Mar;96(3):176.</ref>. | ||
Latest revision as of 22:01, 1 July 2024
Top Contributors - Shreya Pavaskar, Kim Jackson, Amanda Ager, Jonathan Wong, Pacifique Dusabeyezu and Rucha Gadgil
Purpose[edit | edit source]
The Full Can Test is used to assess the function of the Supraspinatus muscle and tendon of the shoulder complex.
Technique[edit | edit source]
The patient can be seated or standing for this test, holding their arm at 90° of elevation in the scapular plane (30° anterior to the frontal plane) with full external rotation of the glenohumeral joint. In this position, the patient's thumb should be pointing up. The therapist should stabilize the shoulder while applying a downward force to the arm whilst the patient tries to resist this motion.
There is no firm consensus on the result of this test, some studies have indicated that a positive full can test is indicated by shoulder pain and/ or shoulder elevation weakness and is suggestive of rotator cuff disease [1][2].
However, an RCT suggests that weakness should be considered the gold standard during interpretation of the test results, due to higher diagnostic accuracy and correlation with arthroscopic findings[1].
Evidence[edit | edit source]
Kelly et al. reported that the full-can test for assessment of supraspinatus function had similar electromyographic (EMG) activity compared with the Empty Can Test, but that it provoked less pain. Their findings showed no significant difference in supraspinatus muscle activation with variation in humeral rotation. There is slightly less activation of the infraspinatus muscle leading to a better isolation of the muscle. [4] It is also suggested that in this testing position, there is less activity of surrounding muscles such as deltoid and subscapularis.[5]
The Full Can Test had a sensitivity of 70% (95% CI=59% to 82%) and a specificity of 81% (95% CI=74% to 88%)[6].
Clinical Application[edit | edit source]
A combination of diagnostic tests for supraspinatus tendon tears including the empty can, full can, and the zero-degree abduction tests showed the best AUC (0.795) and hence the best diagnostic value. The combination also had the highest correlation with intraoperative findings, according to a recent RCT[1]. The same study suggested that the full can test was unable to determine between partial thickness and full thickness tears of the supraspinatus tendon[1]. The full can test also showed better diagnostic value and higher correlation with intraoperative results for tears at least 1 cm in size[1].
It is however, questionable on the value that the ‘full can’ test provides, due to the fact that the test does not selectively isolate supraspinatus. EMG studies conducted during the ‘full can’ test showed that 13 muscles were activated in 15 normal subjects[7]. A paper concluded that shoulder ‘special tests’ should only be considered as pain-provocation tests[8].
Additional Resources[edit | edit source]
Anatomy of Shoulder - Acromioclavicular joint, Glenohumeral joint, Sternoclavicular joint and Scapulothoracic joint
Examination of shoulder and Special tests
Common conditions - Frozen Shoulder, Biceps Tendonitis, Rotator Cuff Tears and Shoulder Instability.
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1.4 Sgroi M, Loitsch T, Reichel H, Kappe T. Diagnostic Value of Clinical Tests for Supraspinatus Tendon Tears. Arthroscopy. 2018;34(8):2326–33.
- ↑ Timmons MK, Yesilyaprak SS, Ericksen J, Michener LA. Full can test: Mechanisms of a positive test in patients with shoulder pain. Clin Biomech [Internet]. 2017;42:9–13.
- ↑ Ccedseminars. Full Can Test. Available from: https://www.youtube.com/watch?v=SGEIKmiP09s [last accessed 1/7/2024]
- ↑ Kelly BT, Kadrmas WR, Speer KP. The manual muscle examination for rotator cuff strength: an electromyographic investigation. The American journal of sports medicine. 1996 Sep;24(5):581-8.
- ↑ Lee CK, Itoi E, Kim SJ, Lee SC, Suh KT. Comparison of muscle activity in the empty-can and full-can testing positions using 18 F-FDG PET/CT. Journal of orthopaedic surgery and research. 2014 Dec;9(1):1-8.
- ↑ Jain NB, Luz J, Higgins LD, Dong Y, Warner JJ, Matzkin E, Katz JN. The diagnostic accuracy of special tests for rotator cuff tear: the ROW cohort study. American journal of physical medicine & rehabilitation. 2017 Mar;96(3):176.
- ↑ Boettcher, Craig E et al. “The 'empty can' and 'full can' tests do not selectively activate supraspinatus.” Journal of science and medicine in sport vol. 12,4 (2009): 435-9. doi:10.1016/j.jsams.2008.09.005
- ↑ Salamh P, Lewis J. It is time to put special tests for rotator cuff-related shoulder pain out to pasture. The journal of orthopaedic and sports physical therapy. 2020;50(5):222–5.
