The Hug-up Test: A New, Sensitive Diagnostic Test for Supraspinatus Tears

We developed a new test, the "hug-up test," wherein elevation is resisted as the palm is held on the opposite shoulder with the elbow held in maximal anterior translation. The purpose of this study was to describe the hug-up test and compare it with other conventional tests used for diagnosing supraspinatus tears.

Study Overview

• Status: Completed
• Conditions: Rotator Cuff Tears
• Intervention / Treatment: Diagnostic test: The hug-up test; Diagnostic test: EC test; Diagnostic test: FC test; Diagnostic test: Neer impingement sign; Diagnostic test: Hawkins-Kennedy impingement sign; Diagnostic test: diagnostic arthroscopy

Detailed Description

The supraspinatus tendon is the most commonly affected tendon in rotator cuff tears. Early detection of a supraspinatus tear using an accurate physical examination is, therefore, important. However, the currently used physical tests for detecting supraspinatus tears are poor diagnostic indicators and involve a wide range of sensitivity and specificity values. Therefore, the aim of this study was to establish a new physical test for the diagnosis of supraspinatus tears and evaluate its accuracy in comparison with conventional tests.

Between November 2012 and January 2014, 200 consecutive patients undergoing shoulder arthroscopy were prospectively evaluated preoperatively. The hug-up test, empty can (EC) test, full can (FC) test, Neer impingement sign, and Hawkins-Kennedy impingement sign were used and compared statistically for their accuracy in terms of supraspinatus tears, with arthroscopic findings as the gold standard. Muscle strength was precisely quantified using an electronic digital tensiometer.

• Study Type: Observational
• Enrollment (Actual): 200

Contacts and Locations

Study Locations

• China
  • Beijing
    • Beijing, Beijing, China, 100191
      • Peking University Third Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

200 consecutive patients scheduled to undergo an arthroscopic procedure for a diagnosis related to shoulder pain and/or weakness or dislocation by one of the senior authors.

Description

Inclusion Criteria:

• patients scheduled to undergo an arthroscopic procedure for a diagnosis related to shoulder pain and/or weakness or dislocation by one of the senior authors from November 2012 to January 2014

Exclusion Criteria:

• Patients with a history of shoulder surgery, upper extremity fractures, and bilateral shoulder diseases.

Study Plan

How is the study designed?

Design Details

• Observational Models: Other
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

P; patients suffering form shoulder pain and/or weakness or dislication

Diagnostic test: The hug-up test; It is a new physical test used to detect supraspinatus tear; Diagnostic test: EC test; It is a traditional physical test used to detect supraspinatus tear; Diagnostic test: FC test; It is a traditional physical test used to detect supraspinatus tear; Diagnostic test: Neer impingement sign; It is a traditional physical test used to detect supraspinatus tear; Diagnostic test: Hawkins-Kennedy impingement sign; It is a traditional physical test used to detect supraspinatus tear; Diagnostic test: diagnostic arthroscopy; The arthroscopic operation involved complete inspection of the supraspinatus. Supraspinatus tears were categorized as fullthickness tears (FTTs), which were classified as small (≤1 cm), moderate (≤3 cm), large (≤5 cm), and massive (>5 cm), on the basis of the largest dimension, and partial-thickness tears (PTTs), which were classified as bursal-sided, articular-sided,and intra-tendinous. Other combined diseases including acromioclavicular joint derangement, infraspinatus lesions, subscapularis lesions, superior labrum anterior and posterior (SLAP) lesions, biceps disorders, and Bankart lesions were recorded as well to assess the specificity of the tests.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
patients' self-reported pain	Pain experienced during the Neer impingement and Hawkins-Kennedy impingement tests and weakness during the EC test and the FC test were considered positive results.	immediately after the test
diagnostic arthroscopy	The arthroscopic operation involved complete inspection of the supraspinatus. Supraspinatus tears were categorized as fullthickness tears (FTTs), which were classified as small (≤1 cm), moderate (≤3 cm), large (≤5 cm), and massive (>5 cm), on the basis of the largest dimension, and partial-thickness tears (PTTs), which were classified as bursal-sided, articular-sided,and intra-tendinous. Other combined diseases including acromioclavicular joint derangement, infraspinatus lesions, subscapularis lesions, superior labrum anterior and posterior (SLAP) lesions, biceps disorders, and Bankart lesions were recorded as well to assess the specificity of the tests.the supraspinatus. Supraspinatus tears were categorized as fullthickness tears (FTTs), which were classified as small (≤1 cm), moderate (≤3 cm), large (≤5 cm), and massive (>5 cm), on the basis of the largest dimension, and partial-thickness tears (PTTs), which were classified as bursal-sided, articular-sided,	during the arthrosocpic procedure

Collaborators and Investigators

• Sponsor: Peking University Third Hospital
• Investigators: Study Chair: Yulei Liu, Peking University Third Hospital

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2012
• Primary Completion (Actual): January 31, 2014
• Study Completion (Actual): January 31, 2014

Study Registration Dates

• First Submitted: July 5, 2021
• First Submitted That Met QC Criteria: July 5, 2021
• First Posted (Actual): July 8, 2021

Study Record Updates

• Last Update Posted (Actual): July 8, 2021
• Last Update Submitted That Met QC Criteria: July 5, 2021
• Last Verified: July 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Rupture; Shoulder Injuries; Tendon Injuries; Rotator Cuff Injuries
• Other Study ID Numbers: 2014156

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No