Testes de tensão selectiva do supra espinhoso e bolsa sub-deltoidea: valores de diagnóstico

Ruano, Teresa; Macedo, Rui

http://hdl.handle.net/10400.26/8692

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Authors

Ruano, Teresa

Macedo, Rui

Abstract(s)

Objectives: To assess validity of two of Cyriax’s commonly used shoulder’s tests: the Resisted AbductionTest (TAbdR) for Supra spinatus and Resisted Abduction Test performed in supine and with traction (TDistr) for Subacromialis Bursae. Determine their specificity and sensitivity using the Magnetic Resonance Imagery (MRI) a shoulder diagnostic gold standard. Methods: 26 patients previously referred for shoulder MRI, were assessed by a manual therapy expert, Cyriax’s trained with 12 years post training extensive practice in shoulder assessment who performed a interview and a complete Cyriax’s shoulder examination, including the additional (TDistr). The physiotherapist didn’t have previous knowledge either of the referral motive or of the MRI results. MRI was performed using the same protocol and results were assessed by a medical imagery expert who ad no knowledge of physiotherapist’s results. Results and Conclusion: Cyriax’s TAbdR test presented 100% sensitivity, 33% specificity, positive near 1, Likelihood Ratio (+LR) and negative 0,0 Likelihood Ratio (-LR). The diagnostic value being irrelevant for changing the probability of Supraspinatus involvement. TDistr test presented 88% sensitivity 87% specificity (+LR) 7,1 and (-LR) 0,11 showing it can be of use in detecting Sub-acromialis Bursae lesions/involvement. Combined use of TAbdR and TDistr for differential diagnostic purposes presents (+LR) 7,5 e (-LR) 0,18 which slightly increases post-test probability of tendititis / tendinosis detection.Results from Cyriax’s shoulder assessment approach present a substantial agreement with MRI diagnosis.