Roos Stress Test (Elevated arm stress test)

A special test for thoracic outlet syndrome

Authors

Affiliations

Nathaniel Yomogida, B.S., SPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, B.S., SPT

Doctor of Physical Therapy

B.A. in Neuroscience

• AKA
  • Roos Stress Test
  • Elevated arm stress test (EAST)

The Roos Stress test is a special test that rules in thoracic outlet syndrome by loading the plexus thru TOS container¹.

Technique

• Patient is seated
• Arm is in 90° Abduction and 90° Elbow flexion
• Patient performs slow finger clenching for 3 min

Interpretation

Note

Patient may display reduced/obliterated radial pulse and have an audible infraclavicular bruit but these are not considered positive tests²

• (+) Patient unable to maintain arms in start position for 3 min²
• (+) Involved side symptoms²
  • Pain
  • Heaviness
  • Numbness/tingling

References

1.

Hooper TL, Denton J, McGalliard MK, Brismée JM, Sizer PS. Thoracic outlet syndrome: A controversial clinical condition. Part 1: Anatomy, and clinical examination/diagnosis. The Journal of Manual & Manipulative Therapy. 2010;18(2):74-83. doi:10.1179/106698110X12640740712734

2.

Dutton M. Dutton’s Orthopaedic Examination, Evaluation, and Intervention. 5th ed. McGraw Hill Education; 2020.