Shoulder Abduction Relief Test

The shoulder abduction relief test, also called Bakody's test, is a medical maneuver used to evaluate for cervical radiculopathy.[1] Specifically, this test is used to evaluate for nerve root compression at C5-C7. It is often used when a patient presents with neck pain that radiates down the ipsilateral upper extremity.[2] The patient's shoulder is abducted by lifting the affected arm above their head either actively or passively. A decrease in radicular symptoms upon shoulder abduction would be considered a positive Bakody's sign and is indicative of nerve root compression.[3]

Shoulder Abduction Relief Test
Purposeassess nerve root pain

Mechanism

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Reduced tension at the nerve root upon shoulder abduction has been identified as the probable mechanism that leads to relief of the pain.[4] Studies on the effect of shoulder abduction on neuroforaminal pressures have provided some support for this claim.[2]

Accuracy

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A 2007 meta-analysis described the shoulder abduction relief test as having low to moderate sensitivity and moderate to high specificity.[5] Another study in 1981 found that 15 of 22 patients with unremitting radicular pain reported relief with shoulder abduction.[1]

References

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  1. ^ a b Davidson, R. I.; Dunn, E. J.; Metzmaker, J. N. (1981). "The shoulder abduction test in the diagnosis of radicular pain in cervical extradural compressive monoradiculopathies". Spine. 6 (5): 441–446. doi:10.1097/00007632-198109000-00004. ISSN 0362-2436. PMID 7302677. S2CID 23523267.
  2. ^ a b Farmer, J. C.; Wisneski, R. J. (1994-08-15). "Cervical spine nerve root compression. An analysis of neuroforaminal pressures with varying head and arm positions". Spine. 19 (16): 1850–1855. doi:10.1097/00007632-199408150-00010. ISSN 0362-2436. PMID 7973984. S2CID 21584580.
  3. ^ "Bakody sign | Taber's Medical Dictionary". www.tabers.com. Retrieved 29 August 2023.
  4. ^ Fast, A.; Parikh, S.; Marin, E. L. (May 1989). "The shoulder abduction relief sign in cervical radiculopathy". Archives of Physical Medicine and Rehabilitation. 70 (5): 402–403. ISSN 0003-9993. PMID 2719545.
  5. ^ Rubinstein, Sidney M.; Pool, Jan J. M.; van Tulder, Maurits W.; Riphagen, Ingrid I.; de Vet, Henrica C. W. (March 2007). "A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy". European Spine Journal. 16 (3): 307–319. doi:10.1007/s00586-006-0225-6. ISSN 0940-6719. PMC 2200707. PMID 17013656.