Lo, Am J Sports Med 2004 - An Evaluation of the Apprehension, Relocation, and Surprise Tests for Anterior Shoulder Instability - Article Summary

An Evaluation of the Apprehension, Relocation, and Surprise Tests for Anterior Shoulder Instability

Lo, Kirkley, et al.·Am J Sports Med·2004·169 citations·Retrospective cohort

Background

Although there are many studies describing tests for shoulder instability, there are few assessing the validity of these tests in diagnosing anterior shoulder instability.

Purpose

To assess the validity of the apprehension, relocation, and surprise tests as predictors of anterior shoulder instability.

Methods

Study Design: Retrospective review of prospectively collected data.

46 patients with a clear diagnosis of one of the following shoulder disorders were evaluated by 4 independent, blinded examiners: traumatic anterior instability (18), rotator cuff tendinosis (17), posterior instability (2), glenohumeral osteoarthritis (4), or multidirectional instability (5). Interobserver reliability was also determined.

Results

In subjects who had a feeling of apprehension on all three tests, the mean positive and negative predictive values were 93.6% and 71.9%, respectively.
The surprise test was the single most accurate test (sensitivity = 63.89%; specificity = 98.91%).
An improvement in the feeling of apprehension or pain with the relocation test added little to the value of the tests.
Interobserver reliability was determined to be 0.83.

Conclusions

The results of this study suggest that a positive instability exam on all three tests is highly specific and predictive of traumatic anterior glenohumeral instability.

Supplemental

An Evaluation of the Apprehension, Relocation, and Surprise Tests for Anterior Shoulder Instability.

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An Evaluation of the Apprehension, Relocation, and Surprise Tests for Anterior Shoulder Instability

Lo, Kirkley, et al.·Am J Sports Med·2004·169 citations·Retrospective cohort

DOI·PubMed

Background

Although there are many studies describing tests for shoulder instability, there are few assessing the validity of these tests in diagnosing anterior shoulder instability.

Purpose

To assess the validity of the apprehension, relocation, and surprise tests as predictors of anterior shoulder instability.

Methods

Study Design: Retrospective review of prospectively collected data.

Results

In subjects who had a feeling of apprehension on all three tests, the mean positive and negative predictive values were 93.6% and 71.9%, respectively.
The surprise test was the single most accurate test (sensitivity = 63.89%; specificity = 98.91%).
An improvement in the feeling of apprehension or pain with the relocation test added little to the value of the tests.
Interobserver reliability was determined to be 0.83.

Conclusions

The results of this study suggest that a positive instability exam on all three tests is highly specific and predictive of traumatic anterior glenohumeral instability.

Background

Although there are many studies describing tests for shoulder instability, there are few assessing the validity of these tests in diagnosing anterior shoulder instability.

Purpose

To assess the validity of the apprehension, relocation, and surprise tests as predictors of anterior shoulder instability.

Methods

Study Design: Retrospective review of prospectively collected data.

Results

In subjects who had a feeling of apprehension on all three tests, the mean positive and negative predictive values were 93.6% and 71.9%, respectively.
The surprise test was the single most accurate test (sensitivity = 63.89%; specificity = 98.91%).
An improvement in the feeling of apprehension or pain with the relocation test added little to the value of the tests.
Interobserver reliability was determined to be 0.83.

Conclusions

The results of this study suggest that a positive instability exam on all three tests is highly specific and predictive of traumatic anterior glenohumeral instability.

Background

Although there are many studies describing tests for shoulder instability, there are few assessing the validity of these tests in diagnosing anterior shoulder instability.

Purpose

To assess the validity of the apprehension, relocation, and surprise tests as predictors of anterior shoulder instability.

Methods

Study Design: Retrospective review of prospectively collected data.

Results

In subjects who had a feeling of apprehension on all three tests, the mean positive and negative predictive values were 93.6% and 71.9%, respectively.
The surprise test was the single most accurate test (sensitivity = 63.89%; specificity = 98.91%).
An improvement in the feeling of apprehension or pain with the relocation test added little to the value of the tests.
Interobserver reliability was determined to be 0.83.

Conclusions

The results of this study suggest that a positive instability exam on all three tests is highly specific and predictive of traumatic anterior glenohumeral instability.