Clinical Significance and Diagnostic Accuracy of Special Tests in Rotator Cuff Related Shoulder Pain

Special tests are typically used to assist in the diagnostic process by implicating specific tissue structures that are either dysfunctional, pathological, or lack structural integrity, confirming the findings from the physical assessment and providing a tentative diagnosis (Magee, 2014). Special testing of the shoulder is generally performed following a full examination of the shoulder (Biederwolf, 2013). Reproduction of pain, and weakness during these special tests are considered clinically diagnostic.

A recent systematic review identified a lack of high-quality studies evaluating inter-rater as well as intra-rater reliability of 62 specific special tests for the diagnosis of shoulder pathologies (Lange et al., 2017). Another study (Ujsasi et al., 2022) reviewed the applicability of special tests in the diagnosis of rotator cuff muscle Injuries of university athletes after comparing the results with ultrasonographic testing of the muscles and concluded that special tests are good predictors of soft tissue changes in the muscles of the rotator cuff of the shoulder; however, they call for further monitoring and analysis on larger numbers.

In contrast, other researchers have questioned the validity and usefulness of the shoulder special tests; suggesting they should be put out to pasture (Salamh & Lewis, 2020).

We are looking for a PhD student who would like to develop an in-depth mixed-methods study to enhance our understanding of: (i) which special tests are currently used by NHS physiotherapists and (ii) the evidence of their diagnostic accuracy. This multi-disciplinary, collaborative study will be conducted across both UW and NHS environments, offering an opportunity for the successful applicant to develop an applied, impactful research study which could enhance physiotherapy practice and patient experience and outcomes in this important area.

Application Process

To begin the application process please go to https://www.worcester.ac.uk/courses/medical-sciences-mphilphd and click on ‘How to Apply’ in the top menu. This PhD could be caried out on a part time or full time basis so please select the relevant application link. On the application form, please make it clear that you are applying for one of our advertised projects so we can direct it straight to the relevant people.

The Interview

All successful applicants will be offered an interview with the proposed Supervisory Team. You will be contacted by a member of the Research School Team to find a suitable date. Interviews can be conducted in person or over Microsoft Teams.

Funding your PhD:

For information about Doctoral Loans please visit: https://www.worc.ac.uk/study/fees-and-finance/doctoral-loans.aspx

During your PhD you can access the Research Student Support Scheme to support dissemination costs associated with your research, up to £500 a year.

Research Group

Living Well with Long-Term Conditions Research Group

Approximately 15 million people in England, representing 1 in 4 adults, have one or more long-term conditions (LTCs). A LTC is an illness that cannot be cured but may be controlled with medicines or other treatments. People living with LTCs face considerable challenges around the management of their long-term physical and mental health.

The ‘Living Well with Long-Term Conditions’ Research Group aims to facilitate the development and implementation of high-quality research and knowledge exchange, targeted at helping people with long-term conditions and their families to live well.

Supervisory team

Director of Studies:

Dr Konstantinos Papadopoulos (Head of Department for Occupational Therapy, Physiotherapy and Nutritional Therapy courses) LWLTC co-lead, Living with Long Term Conditions Research Group, School of Allied Health and Community, University of Worcester

Supervisors:

Dr Dez Kyte, (Senior Lecturer Physiotherapy, Living with Long Term Conditions Research Group) School of Allied Health and Community, University of Worcester

Research Group: Living Well with Long-Term Conditions

For further information or an informal discussion on this project, please contact Dr Konstantinos Papadopoulos (Direct of Studies) via email at k.papadopoulos@worc.ac.uk