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Trial registered on ANZCTR
Registration number
ACTRN12610000352000
Ethics application status
Approved
Date submitted
22/04/2010
Date registered
3/05/2010
Date last updated
3/05/2010
Type of registration
Retrospectively registered
Titles & IDs
Public title
The Bell-van Riet test of the acromio-clavicular (AC) Joint
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Scientific title
Clinical evaluation of acromioclavicular joint pathology: Sensitivity of the Bell-van Riet (BvR) test
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Secondary ID [1]
251661
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None
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Universal Trial Number (UTN)
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Trial acronym
BvRTest
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Localised acromioclavicular pain
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Condition category
Condition code
Musculoskeletal
257365
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The patient stands facing the examiner and the shoulder is passively elevated to 90 degrees, and then fully adducted. The elbow is then extended, with the shoulder in internal rotation (IR) and the forearm pronated. During this manoeuvre, the examiner supports the arm of the patient with his opposite hand, while resting the other hand on the patient’s opposite shoulder to maintain adduction and to prevent rotation of the patient’s upper body. If pain is present, this is considered to be a positive cross arm adduction sign. The patient is then asked to resist the examiner’s downwards force on the forearm . In a positive BvR test, this results in pain and the inability of the patient to maintain the arm in the adducted and elevated position. As a further assessment in this study the test was then repeated with the adducted arm in external rotation (ER). This test is performed once only for diagnostic purposes and takes approximately 7 seconds to complete
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Intervention code [1]
256347
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Diagnosis / Prognosis
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Comparator / control treatment
Nil
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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If pain is present, this is considered to be a positive cross arm adduction sign. The patient is then asked to resist the examiner's downwards force on the forearm . In a positive BvR test, this results in pain and the inability of the patient to maintain the arm in the adducted and elevated position.
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Assessment method [1]
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Timepoint [1]
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All patients undergo 5 shoulder impingement tests including the BVR test. These are used in random order to avoid the influence of fatigue. Each test is performed once only pre-operatively for diagnosis.
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Primary outcome [2]
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To assess the efficacy of the BvR test compared with cross body adduction, O'Brien's active compression test, Paxinos test and Jacob's test. These clinical examination tests are evaluated by the clinician by palpation, performance of controlled movement of the arm across the chest, and response to resisted movement
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Assessment method [2]
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Timepoint [2]
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Pre-operatively once only
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Secondary outcome [1]
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NIL
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Assessment method [1]
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Timepoint [1]
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NIL
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Eligibility
Key inclusion criteria
ALL patients with isolated AC (acromio clavicular ) joint symptoms were included sequentially in this study, INCLUSION CRITERIA were defined as the presence of localised AC joint tenderness or at least one positive AC joint compression tests. In addition, all post-injection tests had to be negative for patients to be included.
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Minimum age
20
Years
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Maximum age
85
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Exclusion criteria included; previous surgery to the AC joint or rotator cuff, diminished rotator cuff strength or positive impingement signs, diminished passive glenohumeral movement, and patients with a known allergy to local anaesthetics or previous adverse reactions to corticosteroid injections elsewhere in the body
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sequential patients with isolated AC joint symptoms were included in this study This was assessed by the presence of localised AC joint tenderness or at least one positive AC joint compression test.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Sequential- non randomised
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/09/2005
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
58
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
A/Prof. Simon Bell
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Address
Melbourne Shoulder and Elbow Centre
31 Normanby St.,
Brighton 3186
Vic
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Nil
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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There was no Ethics permission required as this was a comparative assessment of standard diagnostic techniques currently used by clinicians. All patients gave signed informed consent and were de-identified.
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Ethics committee address [1]
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Ethics committee country [1]
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Date submitted for ethics approval [1]
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01/08/2005
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Approval date [1]
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01/09/2005
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Ethics approval number [1]
258871
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1/08/2005
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Summary
Brief summary
Acromioclavicular (AC) joint pathology is a common cause of shoulder pain. The location of pain originating from the AC joint can be diverse and patients are often not able to identify the exact location. In most patients the pain will be located in an area bounded by the mid-part of the clavicle and the deltoid insertion, but the pain has also been shown to radiate to the radial side of the forearm into the thumb. AC joint pathology can occur in isolation, but is often associated with other causes of shoulder pain, such as subacromial impingement or rotator cuff pathology. Surgical treatment of other causes of shoulder pain can affect the AC joint, and arthroscopic acromioplasty may have detrimental effects on an already compromised AC joint. Conversely, residual AC joint pathology has been shown to have a negative effect on the outcome of surgery to the rotator cuff. Detection of AC joint pathology is therefore crucial in the treatment of patients with any type of shoulder problem and various clinical tests have been described to asses AC joint pathology. The primary aim of this study was to assess the diagnostic sensitivity of the BvR (Bell-van Riet) test, when compared with other tests.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Jennifer Coghlan
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Address
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Melbourne Shoulder and Elbow Centre
31 Normanby St.,Brighton 3186. Vic
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Country
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Australia
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Phone
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61 3 95923775
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Fax
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61 3 95929612
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Email
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[email protected]
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Contact person for scientific queries
Name
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A/Professor Simon Bell
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Address
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Melbourne Shoulder and Elbow Centre
31 Normanby St.,Brighton 3186. Vic
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Country
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Australia
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Phone
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61 3 95928028
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Fax
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61 3 95929612
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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