The patient, Derek, was initially diagnosed with an AC-SC joint separation as a result of a football injury. The diagnosis was then modified to include a periosteal avulsion of the clavicle about four weeks post injury. Derek was immobilized for a total of 8 weeks and was then referred to physical therapy.
At the time I evaluated Derek, I was not aware of CPG, how to interpret research, and how to determine if special tests were valid tests. I evaluated and treated Derek based on what I learned in college, from peers, and from continuing education courses. I chose to perform the Cross-Body Adduction Test, diagnosing an AC joint lesion, by passively flexing Derek’s shoulder to 90o followed by horizontal adduction.
According to Chronopoulos et al, the Cross-body adduction test had the greatest sensitivity for diagnosing chronic acromioclavicular injuries
…show more content…
The phases included pain reduction, developing scapular stability, increasing ROM, muscular strengthening, and focusing on sensory motor training. The sensitivity was 76% and the ICC was listed as 0.41. The average Visual Analogue Scale for pain scores decreased from 6.25 to 0 while the ASORS test improved from the average 71.5 points to 90.5 points. A score of 90 to 100 points was considered to be an excellent result.4
To assess appropriate outcome measures, the Upper Extremity Functional Index (UEFI) and goniometric ROM, was completed at Derek’s initial evaluation and on his final day of treatment. According to Chesworth et al, the 20 question UEFI shows .94 ICC, 4.0 SEM, 9.4 MDC, 80% sensitivity, 68% specificity, 72%PPV, 77% NPV, and 51.2 validity.5 The UEFI was determined to be reliable since it can be easily replicated. The questionnaire is also an acceptable valid tool by measuring what is intended to be