Introducing the Arm Traction Abduction (Ata) Test: A New Diagnostic Method for Subacromial Impingement Syndrome Publisher



Hassabi M ; Halabchi F ; Shams S S ; Mahdaviani B
Source: Muscles, Ligaments and Tendons Journal Published:2026

Abstract

Background: Differentiating Subacromial Impingement Syndrome (SIS) from other shoulder problems through physical examination remains challenging due to the limited sensitivity or specificity of the existing tests, and the difficulty of interpreting the results in patients with significant pain. This study aimed to examine if the Arm Traction Abduction (ATA) maneuver could be used as a non-provocative test for diagnosing SIS. Methods: One hundred patients with shoulder pain lasting less than three months were enrolled. Fifty patients were diagnosed with SIS (Group 1) and the remaining fifty did not have SIS (Group 2). The diagnosis was based on a cut-off point of three positive results out of five impingement tests including Neer, Hawkins-Kennedy, Painful arc, Jobe, and external rotation resistance. Both groups underwent active and passive painless shoulder abduction measurements and the ATA test. ROC curve analysis was used to determine the optimal cut-off value. Results: The ATA test characteristics were calculated as follows: Sensitivity= 55. 5% (CI95%: 0.45-0.65), specificity= 79.8% (CI95%: 0.71-0.87), positive predictive value= 73.7% (CI95%: 0.65-0.81), negative predictive value= 63.7% (CI95%: 0.58-0.69), accuracy= 67.5% (CI95%:0.60-0.75), positive likelihood ratio= 2.74 (CI95%: 1.79-4.21), and negative likelihood ratio = 0.56 (CI95%: 0.44-0.71). A Receiver Operative Characteristics (ROC) curve analysis recommended using a 20-degree improvement in passive abduction as the best cut-off value. Conclusions: We suggest that the ATA test as a new non-provocative test among patients suffering from shoulder pain for differentiating SIS from other problems. This test showed high specificity and patients’ compliance because it did not trigger pain. © 2026 The Author(s).