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DIAGNOSIS OF FROZEN SHOULDER: VALIDATION OF THE CORACOID PAIN TEST: A RESEARCH PROPOSAL

Poster · June 2019

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Michel Gcam Mertens Lotte Meert

University of Antwerp University of Antwerp
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Ariane Schwank Mira Meeus

Kantonsspital Winterthur Ghent University
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Periperhal back muscle dysfunctions and central pain mechanisms: an innovative perspective on the differences between recurrent and chronic pain View project

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 DIAGNOSIS OF FROZEN SHOULDER: VALIDATION OF THE CORACOID PAIN
TEST: A RESEARCH PROPOSAL.
Michel GCAM 1,
Mertens , 2 Lotte 1,
Meert , 2 Ariane Schwank 1, 2, 3 , Mira Meeus1, 2, 4 , Filip Struyf 1
1 Department Rehabilitation sciences and Physiotherapy, University of Antwerp, Belgium
2 Pain in Motion International Research Group, Belgium
3 Department of Physiotherapy, Kantonsspital Winterthur, Winterthur, Switzerland
4 Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium

INTRODUCTION
Frozen shoulder (FS) is a condition characterized by progressive inflammation and fibrosis of the
3
joint capsule and the rotator interval, resulting in restriction of shoulder movement . The
2, 3
prevalence in the general population is 2-5.3% , while the prevalence in patients with Diabetes
Mellitus (DM) is 10-39%. In diabetic patients a significant increase in autonomic symptoms is
found, therefore autonomic dysfunction might also play a role in FS patients.
Carbone et al.1 found a contribution of palpation to the diagnosis FS, with an almost excellent
sensitivity and specificity (98% and 87%) in the palpation over the coracoid process.
Unfortunately we are not aware of other studies which determined the clinimetric properties of
the coracoid pain test.

OBJECTIVE
To test the validity of the coracoid pain test and to obtain possible discriminative validity for subgroups of FS
patients (with DM and autonomic dysfunction).

METHODS
Study design & setting: Diagnostic accuracy study which will be performed in the research laboratory of the
Department of Rehabilitation sciences and Physiotherapy of the University of Antwerp in Antwerp.
Subjects Procedure
Inclusion:
50 FS PATIENTS 1. Primary or secondary freezing phase FS; 1. General questionnaire: demographics, disease status and course, co-
2. PROM >25% decreased in at least 2 motion planes morbidities, work and sport.
and 50% decreased in external rotation2; 2. COMPASS-31: autonomic dysfunction.
3. Pain and movement restriction at least 1 month and 3. Coracoid Pain Test
reached a plateau or deteriorating2.
Exclusion: 4 kg/cm2 1. Coracoid process
1. Improving complaints. 2. AC-joint
vs 1 2 3. Anterolateral
Exclusion: subacromial area
50 Healthy controls 1. > 7 days pain or discomfort in neck-shoulder region
3 Both sides
in past year and intensity NPRS>2/10;
2. Pain or discomfort in >3 body regions >30 days in
past year;
3. History of upper arm or shoulder disorders;
4. Comorbidities;
5. Medication use. A minimum 3 point difference
between the coracoid process
and the other 2 areas is
considered positive.
Statistics
Results within patients: affected and unaffected sides will be compared with a Pearson χ2 test.
Results between participants: patients and healthy participants will be compared with a Pearson χ2 test. Sensitivity
and specificity and their confidence intervals will be determined with a ROC curve. Accuracy will be determined
with the area under the curve.
Possible covariates: COMPASS-31 and presence of DM will be added as covariates to determine whether the
coracoid pain test has different diagnostic value in subgroups of patients with frozen shoulder.

REFERENCES
1. Carbone S, Gumina S, Vestri AR, Postacchini R. Coracoid pain test: a new clinical sign of shoulder adhesive capsulitis. International orthopaedics. 2010;34(3):385-8.
2. Kelley MJ, Shaffer MA, Kuhn JE, et al. Shoulder pain and mobility deficits: adhesive capsulitis. The Journal of orthopaedic and sports physical therapy. 2013;43(5):A1-31.
3. Nagy MT, Macfarlane RJ, Khan Y, Waseem M. The frozen shoulder: myths and realities. The open orthopaedics journal. 2013;7:352-5.

CONTACT
www.uantwerpen.be/en/research-groups/movant/
Michel.mertens@uantwerpen.be @michelmertens4
www.paininmotion.be

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