The champagne toast position isolates the supraspinatus better than the Jobe test: an electromyographic study of shoulder physical examination tests

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• 作者：Peter N. Chalmers ; MD ; ^{p.n.chalmers@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Gregory L. Cvetanovich ; MD ; Noam Kupfer ; MA ; Markus A. Wimmer ; MD ; Nikhil N. Verma ; MD ; Brian J. Cole ; MD ; Anthony A. Romeo ; MD ; Gregory P. Nicholson ; MD
• 关键词：Basic Science Study ; Kinesiology ; Electromyography
• 刊名：Journal of Shoulder and Elbow Surgery
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：25
• 期：2
• 页码：322-329
• 全文大小：1211 K

文摘

While Jobe's test is widely used, it does not isolate supraspinatus activity. Our purpose was to examine the electromyographic (EMG) activity within the supraspinatus and deltoid with resisted abduction to determine the shoulder position that best isolates the activity of the supraspinatus.

Methods

We performed EMG analysis of the supraspinatus, anterior head of the deltoid, and middle head of the deltoid in 10 normal volunteers. We measured EMG activity during resisted shoulder abduction in the scapular plane to both manual resistance and a standardized load in varying degrees of abduction and rotation. To determine which position best isolates supraspinatus activity, the ratio of supraspinatus to deltoid activity (S:D) was calculated for each position. Results were analyzed with a repeated-measures analysis of variance with Bonferroni correction. The posterior deltoid was excluded as it serves mostly to extend and externally rotate.

Results

Our study confirmed Jobe's findings of maximal supraspinatus activity at 90° of abduction. However, decreasing abduction significantly increased S:D for both resisted manual testing and testing against a standardized load (P = .002 and .001, respectively). The greatest S:D ratio (4.6 ± 3.4 for standardized load testing) was seen at the “champagne toast” position, i.e., 30° of abduction, mild external rotation, 30° of flexion, and 90° of elbow flexion. The smallest ratio (0.8 ± 0.6) was seen at Jobe's position.

Conclusions

Testing of abduction strength in the champagne toast position, i.e., 30° of abduction, mild external rotation, and 30° of flexion, better isolates the activity of the supraspinatus from the deltoid than Jobe's “empty can” position.