Orthopedics Book

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Elevated Arm Stress Test

Aka: Elevated Arm Stress Test, Roos Stress Test, EAST Test
  1. Indications
    1. Thoracic Outlet Syndrome
  2. Technique
    1. Step 1: Goal Post Position
      1. Patient abducts both arms to 90 degrees
      2. Both arms are externally rotated
      3. Elbows flexed to 90 degrees
      4. Palms face forward
    2. Step 2: Stress Test
      1. Patient clenches and releases their fists (open and close hands) repoeatedly over a 3 minute period
  3. Interpretation
    1. Negative
      1. Only Forearm muscle Fatigue
    2. Positive
      1. Progressive pain at the neck or Shoulders radiating into the arm
      2. Paresthesias in Forearms and fingers
      3. Severe Fatigue in which patient cannot complete test
      4. Hand palm color may change
        1. Venous obstruction: Plethoric blue, swollen hand
        2. Arterial obstruction: Pale hand
  4. Resources
    1. Physiopedia
      1. https://www.physio-pedia.com/Roos_Stress_Test
  5. References
    1. Mallon and Shoenberger in Herbert (2019) EM:Rap 19(2): 13-15

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