Elevated Arm Stress Test

Other Names

• Roos Stress Test
• Roos Test
• EAST test
• Hands up test
• Roo's Test
• Elevated Arm Stress Test (EAST)

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Purpose

Elevated Arm Stress Test

• Evaluate for Thoracic Outlet Syndrome

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Description

Demonstration of the elevated arm stress test

• Patient is seated with both arms abducted to 90°, elbows flexed to 90° with hands pointed towards the ceiling
• Patient must open and close hands repeatedly over 3 minute period
• Normal: Muscle fatigue
• Abnormal Results
  • Increasing pain progressing down neck and arms
  • Parasthesias
  • Pallor which resolves when arms brought to rest (arterial)
  • Cyanosis and swelling (venous)
  • Inability to complete tests
  • Reproduction of patient symptoms affecting entire extremity

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Pathology

• Thoracic Outlet Syndrome
• Equivocal For
  • Carpal Tunnel Syndrome
  • Cervical Disc Disease
  • Primary shoulder etiology if isolated to shoulder region

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Evidence

Thoracic Outlet Syndrome

• Lee et al
  • Sensitivity: 84%
  • Specificity: 30%
  • PPV: 68%
  • NPV: 50%

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See Also

• Neck Pain (Main)
• Physical Exam Neck

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