Hawkins – Kennedy impingement test for to shoulder :
- This test is used to by doctor in clinic for to check the impingement of shoulder.
- This test is perform when patient is complain about shoulder pain .
- It is mostly check to anterior shoulder impingement causes of this situation is may be to rotator cuff pathology , bicipital paratendenonitis ,scapular or humeral instability .
- This impingement is give to result form structures being compressed into anterior aspect of to humerus between to head of humerus & corocoid process under to acromin process.
What is Purpose of this impingement test ?
- This impingement test is used to identify to subacromial impingement syndrome.
How to perform of this impingement test ?
- Starting position for to test is standing .
- Into standing position the examiner is do the forward flexes up to 90 degrees & also do the elbow flexed up to 90 degrees .
- Then do the forcibly medial rotates means internally rotates of arm to shoulder .
- This movement is pushes to supraspinatus tendon against to anterior surface of to coracoacromical tendon against to anterior surface .
- This test is also perform in different degrees of forward flexion means vertically circling to shoulder / horizontal addcution means horizontally circling to shoulder .
What is result of this impingement test ?
- This test is considered to positive if to patient is experiences to pain with to internal rotation means medial rotation .
- This pain is indicate to supraspinatus paratenonitis or tendinitis & secondary impingement .
What is other part of this test ?
- Corocoid impingement test
- Yocum test
Corocoid impingement test :
- It is describe by to McFarland et al .
- It is same as to Hawkins – Kennedy test but only involves to horizontally adducting to arm across to body 10′ to 20 before doing to medial rotation means internal rotation .
- It is more likely to approximate to lesser tuberosity of to humerus & corocoid process .
Yocum test :
- It is a modification of this test .
- In this test patient is put their hand on to opposite shoulder.
- Then examiner is elevates to elbow.
- In both test pain is indicate to positive test .
Evidence of this impingement test ?
- Sensitivity of this test = 0.62 – 0.92
- Specificity of this test = 0.25 – 1.00
- LR + means Positive Likelihood Ratio =1.20 – 3.33
- LR- means Negative Likelihood Ratio = 0.21 – 0.55
What is importance of this impingement test ?:
- Place to patient into 90 degrees of to shoulder flexion with internal rotation which is decreases to space between to humeral head & underside of to acromion process.
- If space is narrowed for this structures into the subacromial space like as to subacromial bursa or supraspinatus tendon which is become to compressed & elicit of to pain response.
- Most important note = when to test performed alone it does not have to good diagnostic accuracy.
- It is clinician to utilize of to cluster of to identifying of to subacromial impingement which is suspect to patient with this syndrome.
- Into cluster consists of this test is :
- Positive test of Hawkins-Kennedy impingement sign .
- Painful arc of sign .
- Weak / painful of to infraspinatus manual muscle test.
When to this test is become to False Positive
- It is notice by to Macdonald et al (2000)
- It is mostly like as to Internal impingement
- Bankart lesion in 25%
- SLAP lesion in 46.1 %
