Elevated Arm Stress Test – EAST (Roos Stress Test)
- Examines result of loading brachial plexus throughout the thoracic outlet
- Stresses arterial, venous, and nervous systems
- Patient is seated with arms above 90 degrees of abduction, full external rotation, and elbows flexed to 90 degrees, with head in neutral position
- Patient opens and closes hands into fists while holding the arms in the elevated position for 3 minutes
- Positive test: Unable to maintain position for 3 minutes, pain and/or paresthesia, or discontinuation with dropping the arms for pain relief
- Positive test indicates fatigue or arterial compromise
- Monitor onset of symptoms and compare the color of bilateral distal upper extremities
- Greatest sensitivity for neurogenic and vascular TOS
- Most sensitive and specific test to detect neurological thoracic outlet syndrome
(Hooper et. al., 2010 & Watson et. al, 2009)