Drop Arm Test | Indication, Steps and More

The drop arm test is a clinical test employed to physiotherapists in identifying the structural reconfirmation of the rotator cuff especially the supraspinatus muscle. This test aids in showing any lesions or latent or partial rupture of the rotator cuff which is culpable for numerous shoulder aches and dysfunction.

Indication for  Drop Arm Test

The Drop Arm Test is indicated for patients presenting with:

• Pain in the shoulder that is aggravated with overhead work or motion.
• Suspected rotator cuff tear.
• Weakness in shoulder abduction.
• Post-traumatic shoulder injuries.
• Impingement syndrome or tendinopathy chronic conditions of the shoulders.

Steps to Perform  Drop Arm Test

The following steps are described for performance of this type of test:
 

1. Patient Positioning: Arm position, the patient is seated or standing fully with the arm pulled away to the side or at 90 degrees.
2. Instruction: The therapist then tells the patient to gradually bring down the arm to their side.
3. Observation: Around the joint the therapist monitors the patient’s coordination regarding the control of the arm’s position in the process of its descent.
4. If the patient cannot lift and slowly lower the arm or if the arm drops suddenly, the test is positive.

Assessment Outcome of  Drop Arm Test

• Positive Test: If the patient is incapable of performing the movement gradually, and bring the arm down to the side while rousing pain, there is high chances of suspicion of rotator cuff tear that highly likely involves the Supraspinatus muscle as a primary rotator cuff muscle.
• Negative Test: The patient is able to slowly put down the arm without any discomfort or jerky movement which implies a functional and intact rotator cuff.

Differential Diagnosis by  Drop Arm Test

The Drop Arm Test is useful in differentiating between:

• Rotator cuff tears and other shoulder related pathology like shoulder impingement, bursitis or frozen shoulder that affects the joint.
• Supraspinatus muscle involvement and other rotator cuff muscles.
• Shoulder instability or rotator cuff tear

Related  Drop Arm Test

• Empty Can Test: Determines the stability of the muscle by evaluating capability of the supraspinatus muscle of the shoulder joint.
• Hawkins-Kennedy Impingement Test: Diagnosis subacromial impingement.
• Neer Impingement Test: Identifying shoulder impingement is an important role for which the ROM is assessed..
• Infraspinatus Test: Tests for the strength of the infraspinatus muscle.

Evidence-Based Physiotherapy Researches For Rotator Cuff Injury

• Rehabilitation Strategies: Some of the studies recommend individual rehabilitation regimens of superiority in strengthening rotator cuff muscles and performing scapular stabilization for persons with positive Drop Arm Tests.
• Early Diagnosis and Management: Treatment for rotator cuff tears may require physiotherapy, and, in some cases, may be surgical and if started early then there are elevated chances of better outcome.
• Advanced Imaging Techniques: MRI and ultrasound utilization could help in improvement of clinical tests for diagnosis.
• Long-Term Follow-Up Studies: Future studies comparing long-term results of patients who undergo conservative treatment for their rotator cuff tear to those who undergo surgical intervention can help in proving which treatment modality is effective or not effectively.

Key References:

1. Kim, D. H. , & ElAttrache, N. S. (2020). Rotator Cuff Tear: Early Diagnosis & Management. Journal of Orthopaedic Surgery.
2. Determined by Burbank, K. M, Stevenson, J. H and Czarnecki, G. R 2018 Management of Rotator Cuff Injury. American Family Physician.
3. Jain, N. B. , & Higgins, L. D. (2019). Rotator Cuff Tear and Shoulder Impingement: A Review ` Inspired By ‘The Godfather’. Sports Medicine.
4. Therefore, including these steps and insights, physiotherapists can apply the Drop Arm Test to rotator cuff pathologies’ diagnosis and management, aligned with the evidence.