The Hug-up Test: A New, Sensitive Diagnostic Test for Supraspinatus Tears

Study Overview
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Brief Summary
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We developed a new test, the hug-up test, wherein elevation is resisted as the palm is held on the opposite shoulder with the elbow held in maximal anterior translation. The purpose of this study was to describe the hug-up test and compare it with other conventional tests used for diagnosing supraspinatus tears.

Detailed Description
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The supraspinatus tendon is the most commonly affected tendon in rotator cuff tears. Early detection of a supraspinatus tear using an accurate physical examination is, therefore, important. However, the currently used physical tests for detecting supraspinatus tears are poor diagnostic indicators and involve a wide range of sensitivity and specificity values. Therefore, the aim of this study was to establish a new physical test for the diagnosis of supraspinatus tears and evaluate its accuracy in comparison with conventional tests. Between November 2012 and January 2014, 200 consecutive patients undergoing shoulder arthroscopy were prospectively evaluated preoperatively. The hug-up test, empty can (EC) test, full can (FC) test, Neer impingement sign, and Hawkins-Kennedy impingement sign were used and compared statistically for their accuracy in terms of supraspinatus tears, with arthroscopic findings as the gold standard. Muscle strength was precisely quantified using an electronic digital tensiometer.

Official Title
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The Hug-up Test: A New, Sensitive Diagnostic Test for Supraspinatus Tears

Conditions
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Rotator Cuff Tears

Intervention / Treatment
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* Diagnostic Test: The hug-up test
* Diagnostic Test: EC test
* Diagnostic Test: FC test
* Diagnostic Test: Neer impingement sign
* Diagnostic Test: Hawkins-Kennedy impingement sign
* Diagnostic Test: diagnostic arthroscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients scheduled to undergo an arthroscopic procedure for a diagnosis related to shoulder pain and/or weakness or dislocation by one of the senior authors from November 2012 to January 2014 Exclusion Criteria: Patients with a history of shoulder surgery, upper extremity fractures, and bilateral shoulder diseases.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| P<br>patients suffering form shoulder pain and/or weakness or dislication | Diagnostic Test: The hug-up test<br>* It is a new physical test used to detect supraspinatus tear<br>Diagnostic Test: EC test<br>* It is a traditional physical test used to detect supraspinatus tear<br>Diagnostic Test: FC test<br>* It is a traditional physical test used to detect supraspinatus tear<br>Diagnostic Test: Neer impingement sign<br>* It is a traditional physical test used to detect supraspinatus tear<br>Diagnostic Test: Hawkins-Kennedy impingement sign<br>* It is a traditional physical test used to detect supraspinatus tear<br>Diagnostic Test: diagnostic arthroscopy<br>* The arthroscopic operation involved complete inspection of the supraspinatus. Supraspinatus tears were categorized as fullthickness tears (FTTs), which were classified as small (≤1 cm), moderate (≤3 cm), large (≤5 cm), and massive (>5 cm), on the basis of the largest dimension, and partial-thickness tears (PTTs), which were classified as bursal-sided, articular-sided,and intra-tendinous. Other combined diseases including acromioclavicular joint derangement, infraspinatus lesions, subscapularis lesions, superior labrum anterior and posterior (SLAP) lesions, biceps disorders, and Bankart lesions were recorded as well to assess the specificity of the tests.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| patients' self-reported pain | Pain experienced during the Neer impingement and Hawkins-Kennedy impingement tests and weakness during the EC test and the FC test were considered positive results. | immediately after the test | 
| diagnostic arthroscopy | The arthroscopic operation involved complete inspection of the supraspinatus. Supraspinatus tears were categorized as fullthickness tears (FTTs), which were classified as small (≤1 cm), moderate (≤3 cm), large (≤5 cm), and massive (>5 cm), on the basis of the largest dimension, and partial-thickness tears (PTTs), which were classified as bursal-sided, articular-sided,and intra-tendinous. Other combined diseases including acromioclavicular joint derangement, infraspinatus lesions, subscapularis lesions, superior labrum anterior and posterior (SLAP) lesions, biceps disorders, and Bankart lesions were recorded as well to assess the specificity of the tests.the supraspinatus. Supraspinatus tears were categorized as fullthickness tears (FTTs), which were classified as small (≤1 cm), moderate (≤3 cm), large (≤5 cm), and massive (>5 cm), on the basis of the largest dimension, and partial-thickness tears (PTTs), which were classified as bursal-sided, articular-sided, | during the arthrosocpic procedure |