Yocum's Test: Difference between revisions

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<div class="editorbox"> '''Original Editor '''- [[User:Anas Mohamed|Anas Mohamed]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
<div class="editorbox"> '''Original Editor '''- [[User:Anas Mohamed|Anas Mohamed]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>  


=== Purpose ===
=== Purpose ===
'''Yocum's test''' is used to examine the  shoulder rotator cuff impingement.
'''The Yocum's Test''' is used to examine the possibility of a  shoulder [[Rotator Cuff|rotator cuff]] impingement ([[Subacromial Pain Syndrome|subacromial impingement syndrome]]).
 
It is also referred to as the Yocum Maneuvre.  


=== Technique ===
=== Technique ===
'''Step 1'''  Ask the patient to place affected hand on opposite shoulder.


'''Step 2'''  Examiner elevates the elbow.
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.<ref>Yocum LA. Assessing the shoulder. History, physical examination, differential diagnosis, and special tests used, Clin Sports Med, 1983, vol. 2 (pg. 281-9).</ref>
 
'''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 patient experience pain test indicates positive.
'''Step 3'''  If the patient experiences pain or demonstrates signs of apprehension, the test is considered positive.  


{{#ev:youtube|i39VxR1NeSE|300}} <ref>Yocum’s Test - Shoulder impingement Assessment: https://youtu.be/i39VxR1NeSE </ref>
{{#ev:youtube|i39VxR1NeSE|300}} <ref>Yocum’s Test - Shoulder impingement Assessment: https://youtu.be/i39VxR1NeSE </ref>






=== Evidence ===
=== Evidence ===
Yocum's test is the very sensitive and very accurate for subacromial impingement syndrome (SIS).<ref>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</ref>
 
Table 1: PE findings in MRI-confirmed Subacromial impingement syndrome (Silva et al. 2008)<ref>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, <nowiki>https://doi.org/10.1093/rheumatology/ken101</nowiki></ref>
{| class="wikitable"
!
!
! colspan="2" |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
|
|
|
|
|
|
|-
| rowspan="2" |Passive ABD
| +
|14
|9
|73.7
|10.0
|60.9
|16.7
|51.7
|0.82 (0.58, 1.15)
|-
|−
|5
|1
|
|
|
|
|
|
|-
| rowspan="2" |Resisted ABD
| +
|11
|8
|57.9
|20.0
|57.9
|20.0
|44.8
|0.72 (0.44, 1.18)
|-
|−
|8
|2
|
|
|
|
|
|
|}
Yocum's Test has a good level of sensitivity (79%) and specificity (40%) for SIS.<ref>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</ref>


== References  ==
== References  ==

Revision as of 20:09, 8 January 2021

Original Editor - Anas Mohamed Top Contributors - Anas Mohamed, Amanda Ager and Kim Jackson

Purpose[edit | edit source]

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[edit | edit source]

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[edit | edit source]

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

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

References[edit | edit source]

  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
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