Summary

The Champagne Pour position of manual muscle testing elicited pain that significantly correlated with supraspinatus A-P dimension and total area of rotator cuff tears.

Abstract

Background

The “Champagne Toast” and “Champagne Pour” arm positions of manual muscle testing revealed a better isolation of supraspinatus activity compared to the Jobe test in a previous EMG study. The purpose of this study was to evaluate the clinical utility of preoperative “Champagne Toast” and “Champagne Pour” positions in patients with known rotator cuff tears undergoing rotator cuff repair (RCR) with regard to tear location and size.

Methods

77 consecutive shoulders undergoing arthroscopic RCR were analyzed. There were 31(40%) female and 46(60%) male with an average age of 57.8 years (40-76). 68 (88%) of patients were right hand dominant, while 9 (12%) were left hand dominant, with the operative side being the right in 58%. An independent examiner performed manual muscle test examination trials for Toast, Pour, Jobe test, External rotation (ER) at side, and Belly press. The results of clinical pain and weakness responses were classified preoperatively.
Intraoperatively, tear size (A-P, M-L dimensions), tear location (anterior, central, and/or posterior within the supraspinatus), and status of the anterior band of the supraspinatus (intact/not intact) were recorded.We excluded any shoulders with previous surgery, stiffness, or neurologic conditions.Preoperative MRI were independently evaluated for tear location, size, and muscle grading (Goutallier).Descriptive statistical analysis with One-way ANOVA was performed for correlations between the tests and tear dimensions, area, location, and the status of the anterior band of the supraspinatus.

Results

Significant correlations were seen between pain rating in the Champagne Pour position and greater tear area (p=.037) and larger A-P dimension(p=.011). ER at side weakness trended toward a significant association with anterior supraspinatus tear location (p=.062). No significant correlations were seen between other preoperative physical exams and tear location, and no physical exam test results were associated with intraoperative status of the anterior band of the supraspinatus. The Jobe test for either pain or weakness did not clinically correlate to known rotator cuff tear size, location, or area.

Conclusion

The Champagne Pour position of manual muscle testing for supraspinatus activity elicited pain that significantly correlated with supraspinatus A-P dimension and total area of the tear. None of the other manual muscle physical exam tests had significant correlations.