The champagne toast position isolates the supraspinatus better than the Jobe test: an electromyographic study of shoulder physical examination tests

Chalmers, Peter N.; Cvetanovich, Gregory L.; Kupfer, Noam; Wimmer, Markus A.; Verma, Nikhil N.; Cole, Brian J.; Romeo, Anthony A.; Nicholson, Gregory P.

doi:10.1016/j.jse.2015.07.031

Cited by 24 publications

(15 citation statements)

References 30 publications

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“…The clinical examination included rotator-cuff (RC) tests (Jobe Test [22], Champagne Toast Test [23], External Rotation Strength Test [24], Patte Test [25], Lift off test [26], Belly Press Test [27], Bear Hug Test [28]), SLAP (O’Brien-Test [29], Supine-Flexion-Resistance-Test [30]) and biceps tendon tests (Yergason Test [31], Speed’s Test [32]), impingement tests (Neer’s test [33], Hawkins Kennedy Test [34]), a clinical evaluation of horizontal and vertical instability by palpation and manipulation as well as range of motion (ROM) testing in a standardized manner. After surgical treatment, horizontal instability was tested for again by manipulation under direct visualization of the AC joint.…”

Section: Methodsmentioning

confidence: 99%

Minimally Invasive AC Joint Reconstruction System (MINAR®) in Modified Triple-Button Technique for the Treatment of Acute AC Joint Dislocation

Breuer

Unterrainer

Komjati³

et al. 2019

JCM

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Acute acromioclavicular (AC) joint dislocation is a frequent sports injury with more than 100 different operation methods described. A total of 65 patients with an acute AC joint dislocation were treated with the modified MINAR® system between 2009 and 2013. Clinical outcome, horizontal and vertical instability, as well as concomitant intraarticular injuries were assessed. We used Zanca, stress and axial X-rays for radiological assessment. A Constant score of 95 (±8.8), University of California Los Angeles Shoulder score (UCLA) of 31 (±4.9), Disabilities of Arm, Shoulder and Hand (DASH) of 9.1 (±14.3), and Visual Analogue Scale (VAS) of 0.9 (±0.126) was found. A total of 30 patients (59%) had no signs of reduction loss, nine patients (18%) a slight loss, 11 patients (22%) a partial loss, and one patient (2%) a total loss. No significant influence on the clinical scores could be shown. The postoperative coracoclavicular (CC) distance negatively affected the Constant (p = 0.007) and UCLA scores (p = 0.035). A longer time interval to surgery had a negative influence on all scores (p ≤ 0.001). We could not find any signs of persistent horizontal instability or intraarticular injuries at follow-up. The MINAR® system promises satisfactory functional and radiological results. When setting the correct indication, patients benefit from an early operation. No persisting horizontal instability was observed following suturing of the AC capsule and the delta fascia.

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Section: Methodsmentioning

confidence: 99%

Minimally Invasive AC Joint Reconstruction System (MINAR®) in Modified Triple-Button Technique for the Treatment of Acute AC Joint Dislocation

Breuer

Unterrainer

Komjati³

et al. 2019

JCM

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“…Abduction strength was collected in accordance with the Constant-Murley assessment with the arm in abduction. However, the supraspinatus muscle could have been better isolated with the “empty can” test 14 or champagne toast, 4 which may enable our results to be more accurate. Improvements in Constant-Murley score after injection were attributable to improvements in strength and range of motion.…”

Section: Discussionmentioning

confidence: 99%

Clinical Function Improves After Subacromial Injection of Local Anesthetic in Full-Thickness Rotator Cuff Tears: A Randomized Control Trial

Forsythe

Agarwalla

Puzzitiello

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Rotator cuff pathology is the most common cause of shoulder pain in adults, accounting for nearly 70% of shoulder-related visits to clinicians. However, physical examination findings may be limited because of pain or patient inhibition. Purpose: To establish whether a relationship exists between pain, range of motion, and strength in patients with a full-thickness rotator cuff tear. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A single-blind, randomized controlled study of 40 patients undergoing rotator cuff repair for full-thickness rotator cuff tears was performed. Patients were randomized to receive either a subacromial 10-mL 2% lidocaine injection or a sham injection, with no contents being injected into the subacromial space. Before the injection, patients were assessed using a visual analog scale for pain (VAS-Pain) as well as the Constant-Murley subjective questionnaire and objective physical examination. The examination was repeated 10 minutes after injection and 6 months postoperatively. VAS-Pain after injection was not assessed. The assessment at 6 months was performed to demonstrate improvement of rotator cuff function after operative management. Statistical analysis included Student t and chi-square tests as well as multivariate binomial logistic regression analyses to identify predictors for improvement after injection. Results were considered significant if P < .05. Results: Range of motion, strength, and Constant-Murley score significantly improved after a subacromial lidocaine injection ( P < .05). Range of motion, strength, Constant-Murley score, and VAS-Pain significantly improved at final follow-up compared with the preinjection assessment for both groups ( P < .05); however, there was no difference ( P > .05) between groups at 6 months postoperatively. Conclusion: After subacromial lidocaine injections, patients exhibited modest but significant improvements in range of motion, strength, and the Constant-Murley score. Pain may limit range of motion and strength in patients with full-thickness rotator cuff tears independent of the mechanical impact of the tear itself. Registration: NCT02693444 ( ClinicalTrials.gov identifier).

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“…Weakness in external rotation may suggest infraspinatus involvement, while subscapularis can be tested with the bear hug, belly press, or lift off signs. True assessment of the supraspinatus requires adequate scapular stabilization and the arm in a position outside of the impingement zone, such as the described champagne toast test [41,42]. Impingement signs such as Neer and Hawkins may be positive; however, these signs are less specific for isolated rotator cuff pathology [43,44].…”

Section: Physical Exammentioning

confidence: 99%

Treatment of Partial Thickness Rotator Cuff Tears in Overhead Athletes

Liu

Garcia

Gowd

et al. 2018

Curr Rev Musculoskelet Med

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Purpose of Review To review the etiology, classification, presentation, evaluation, treatment strategy, and outcomes in overhead athletes with partial thickness rotator cuff tears. Recent Findings Despite advances in surgical repair techniques, return to play following surgical repair of partial rotator cuff tears remains modest at best. Summary Overhead athletes may be particularly prone to rotator cuff pathology due to the supraphysiological strains within the tendon during the throwing motion, as well as mechanical stress with contact between the undersurface of the rotator cuff and the glenoid. The true prevalence of partial tears may be underestimated given the high incidence of asymptomatic tears. Both dynamic ultrasound and enhanced contrast MRI have improved our understanding of this pathology. For most overhead athletes, nonoperative management is the most common course. Despite advances in imaging, diagnosis, and surgical techniques, our ability to return these patients to their elite level is modest at best when nonoperative management fails and surgical treatment is performed. If a surgical route is needed, debridement alone is the most frequent procedure given concerns of over constraint and poor return to play with surgical repair of the partial thickness rotator cuff tear.

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The champagne toast position isolates the supraspinatus better than the Jobe test: an electromyographic study of shoulder physical examination tests

Cited by 24 publications

References 30 publications

Minimally Invasive AC Joint Reconstruction System (MINAR®) in Modified Triple-Button Technique for the Treatment of Acute AC Joint Dislocation

Minimally Invasive AC Joint Reconstruction System (MINAR®) in Modified Triple-Button Technique for the Treatment of Acute AC Joint Dislocation

Clinical Function Improves After Subacromial Injection of Local Anesthetic in Full-Thickness Rotator Cuff Tears: A Randomized Control Trial

Treatment of Partial Thickness Rotator Cuff Tears in Overhead Athletes

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