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Active Compression Test

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Active Compression Test
Clinical demonstration of O'Brien's Test[1]
Demonstration of O'Briens test[2]
Photograph of the active compression test (O'Brien Sign) with the Dines modification (A) or Taylor modification (B). The examiner applies a uniform downward force to the patient's arms as they resist and attempt to maintain 90 of forward flexion. In the Dines modification, the test is performed bilaterally; in the Taylor modification, the contralateral arm is controlled at the wrist with the arm forward flexed to 45.[3]
  • Active Compression Test
  • O'Brien's Test
  • O'Brien's Active Compression Test
  • Active Compression Test
  • O'Brien Test
  • O’Brien Active Compression Test
  • O’Brien’s Active Compression Test
  • O’Brien SLAP Test
  • Active Compression Test for SLAP Lesion
  • SLAP Compression Test
  • Shoulder Active Compression Test

Purpose

Description

  • Patient is seated or standing
  • Shoulder flexed to 90°
  • Patient internally rotates the shoulder and pronates the forearm
  • The instructor then asks the patient to apply an upward force against instructor resistance
  • The patient then externally rotates the shoulder and supinates the forearm
  • The instructor then applies an upward force again against resistance
  • A positive test
    • Pain or clicking when in pronated position that improves in supination position

Pathology

Evidence

Acromioclavicular Joint Pain

  • Flynn et al[4]
    • Sensitivity: 41% - 100%
    • Specificity: 95% - 97%
    • LR+: 8.2 - 33.3
    • LR-: 0.00 - 0.62
  • Walton et al[5]
    • Sensitivity: 16%
    • Specificity: 90%
    • PPV: 62%
    • NPV: 52%
    • Diagnostic accuracy: 53%
  • Chronopoulos et al[6]
    • Overall Accuracy: 92%

Glenoid Labrum Tear

  • Flynn et al[4]
    • Sensitivity: 63% - 100%
    • Specificity: 73% - 98%
    • LR+: 2.30 - 50.0
    • LR-: 0.00 - 0.51
  • Specificity: 28-73% [7]
  • Sensitivity: 63-94% [8]

SLAP Tear

  • Nakagawa et al[9]
    • Sensitivity: 54%
    • Specificity: 60%
    • Accuracy: 57%
    • PPV: 52%
    • NPV: 62%

See Also

References

  1. ↑ Manske, Robert, and Todd Ellenbecker. "Current concepts in shoulder examination of the overhead athlete." International journal of sports physical therapy 8.5 (2013): 554.
  2. ↑ Image courtesy of clinicalgate.com
  3. ↑ Bryan, Matthew R., et al. "A comprehensive review of the physical examination for the biceps-labrum complex of the shoulder." Arthroscopy Techniques 13.12 (2024): 103136.
  4. ↑ 4.0 4.1 Flynn, T.W., Cleland, J.A., Whitman, J.M. (2008). User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. Buckner, Kentucky: Evidence in Motion
  5. ↑ Walton, Judie, et al. "Diagnostic values of tests for acromioclavicular joint pain." JBJS 86.4 (2004): 807-812.
  6. ↑ Chronopoulos E, Kim TK, Park HB, Ashenbrenner D, McFarland EG. Diagnostic value of physical tests for isolated chronic acromioclavicular lesions. Am J Sports Med. 2004 Apr-May;32(3):655-61.
  7. ↑ Ebinger, Nina et al. “A new SLAP test: the supine flexion resistance test.” Arthroscopy: The Journal of Arthroscopic Related Surgery: Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association 24.5 (2008): 500-5.
  8. ↑ Guanche, Carlos A, and Donald C Jones. “Clinical testing for tears of the glenoid labrum.” Arthroscopy: The Journal of Arthroscopic Related Surgery: Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association 19.5: 517-23.
  9. ↑ Nakagawa, Shigeto, et al. "Forced shoulder abduction and elbow flexion test: a new simple clinical test to detect superior labral injury in the throwing shoulder." Arthroscopy: The Journal of Arthroscopic & Related Surgery 21.11 (2005): 1290-1295.
Created by:
John Kiel on 9 July 2019 13:20:09
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Last edited:
18 March 2026 13:12:51
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