Assesses for vascular occlusion at the thoracic outlet.
- Roo’s Test
- Numbness, weakness, tingling, or cold sensations in the upper extremity
Patient Position
- Seated or standing
Examiner Position
- Standing, facing the patient
Steps of Performance
- The patient abducts their shoulders to 90° and externally rotates their humerus
- The patient flexes their elbows to 90°
- Shoulders and elbows should be in the frontal plane
- The patient rapidly opens and closes both hands 2 times per second for 3 minutes
Alternative Methods
The Elevated Arm Stress Test places the shoulder girdle in a position that stresses the neurovascular bundle that is responsible for supplying the upper extremity. Repetitive hand movements increase vascular demand leading to an increased likelihood of developing symptoms in the presence of a suboptimal blood supply.
General
Inability to maintain the testing position
- Thoracic outlet syndrome (TOS)
- Unrelated muscular fatigue and/or pain of the shoulder girdle
Positives
Replication of patient's sensory and/or motor symptoms in the extremity
- vascular thoracic outlet syndrome (vTOS)
- neurogenic thoracic outlet syndrome (nTOS)
Cyanosis and swelling
- vascular thoracic outlet syndrome (vTOS)
Edema or color change
- vascular thoracic outlet syndrome (vTOS)
Pertinent Negatives
- Numbness, weakness, tingling, or cold sensations in the upper extremity
Patient Position
- Seated or standing
Examiner Position
- Standing, facing the patient
Steps of Performance
- The patient abducts their shoulders to 90° and externally rotates their humerus
- The patient flexes their elbows to 90°
- Shoulders and elbows should be in the frontal plane
- The patient rapidly opens and closes both hands 2 times per second for 3 minutes
Alternative Methods
The Elevated Arm Stress Test places the shoulder girdle in a position that stresses the neurovascular bundle that is responsible for supplying the upper extremity. Repetitive hand movements increase vascular demand leading to an increased likelihood of developing symptoms in the presence of a suboptimal blood supply.
General
Inability to maintain the testing position
- Thoracic outlet syndrome (TOS)
- Unrelated muscular fatigue and/or pain of the shoulder girdle
Positives
Replication of patient's sensory and/or motor symptoms in the extremity
- vascular thoracic outlet syndrome (vTOS)
- neurogenic thoracic outlet syndrome (nTOS)
Cyanosis and swelling
- vascular thoracic outlet syndrome (vTOS)
Edema or color change
- vascular thoracic outlet syndrome (vTOS)
Pertinent Negatives