What is a sign of arterial compression during the ROOS Test (EAST, AER)?

In the context of the ROOS Test, also known as the East Test or AER (Active Elevation Relief), a sign of arterial compression is indicated by arm pallor when elevated. When a therapist conducts this test, they ask the patient to hold their arms above their head and make a fist repeatedly. If arterial compression occurs, it limits the blood flow to the arm, which can lead to a lack of oxygenation in the tissues, resulting in pallor.

As the blood supply diminishes, the skin might lose its typical color and appear pale (pallor) due to reduced blood flow. This response is critical because it indicates an issue involving arterial supply, which can result from thoracic outlet syndrome or similar vascular compressive conditions.

While swelling and cyanosis are signs that could indicate other issues such as venous obstruction, they are not characteristic signs of arterial compression specifically during this test. The positive sulcus sign relates more to shoulder instability rather than arterial issues, and arm hyperemia when lowered indicates increased blood flow, which is the opposite of what occurs with arterial compression. Thus, arm pallor when elevated is a clear indicator that supports the diagnosis of arterial compression during the ROOS Test.