back special tests Flashcards
march test
purpose: si joint dysfunction
pt. pos: standing
Prac. pos: standing or sitting behind pt. with both thumbs over the SI joint
procedure: pt is instructed to alternately raise one knee to the chest and prac. will note the movement of SI joint
positive: no movement or unilateral asymmetry in movement
Trendelenburg test
purpose: weakness in glute medius or involvement of superior gluteal nerve
pt. pos: standing
Prac. pos: sitting behind pt.
procedure: pt is instructed to alternately lift one knee to their test while prac. observes hip jolting out
positive: hip jutting laterally or pt is leaning to involved side
heel and toe walking
purpose: neurological involvement/ motor function of lower extremity
pt. pos: standing
Prac. pos: standing next to pt.
procedure: have pt. walk on their toes and then walk on their heels
positive: inability to perform the procedure
stork standing
purpose: check for proprioception
pt. pos: standing
Prac. pos: standing next to pt.
procedure: have the pt. lift one leg and check for balance
positive: inability to perform the test, unable to balance
hip distraction test
purpose: apprehension due to an unstable hip or osteoarthritis or ligamentous issue
pt. pos: supine with test hip flexed to 30 degrees, slightly abducted and slightly externally rotated
Prac. pos: at foot of pt.; holding ankle with both hands
procedure: a distraction force is applied just to the point of the pt. beginning to move
positive: apprehension with distraction= unstable hip or ligamentous
relief of pain= osteoarthritis or leg calf perthes or OCD
hoover test
purpose: malingering or lying pt.
pt. pos: lying on table
Prac. pos: at foot of pt. both heels of pt. cupped in prac. hands
procedure: pt is instructed to raise one leg
positive: failure of the opposite leg to push down on the prac. hand indicated a sub maximal effort
SLR test
purpose: neurological involvement in lower extremity
pt. pos: supine with hip flexed
Prac. pos: standing next to pt. one hand maintaining knee extension and the other on the distal leg
procedure: hip is passively extended to the end of the range of motion. combination movements may be added such as the chin to the chest and/or dorsiflexion
positive: shooting pain, numbness, tingling. pain in the lumbar spine = then it would be indicative of bulging disc
well SLR test
purpose: neurological involvement in the lower extremity
pt. pos: supine with hip flex
Prac. pos: standing next to pt. one hand maintaining knee extension and the other on the distal leg
procedure: the hip passively extended to the end of the range of motion. combination movement may be added such as the chin to the chest and/or dorsiflexion
positive: shooting pain, numbness, tingling down the non-test leg
bowstring test
purpose: neurological involvement of tibial nerve or common perineal nerve
pt. pos: supine
Prac. pos: at foot of pt.
procedure: perform a SLR to the point of pain, flex the knee until pain is relieved then apply pressure to the popliteal fossa with the practitioner’s thumb
positive: reduced to eliminated pain with knee flexion that returns with popliteal pressure
pelvic compression
purpose: SI joint dysfunction
pt. pos: supine
Prac. pos: standing next to pt. arms are crossed and placed on ASIS of pt.
procedure: downward and outward pressure is applied uniformly on ASIS
positive: posterior pain along the SI joint
pelvic distraction
purpose: si joint dysfunction
pt. pos: supine
Prac. pos: next to pt. hands placed on superior portion of gluteus Maximus
procedure: prac. raises both hands, spreading the SI joint
positive: pain in the SI region
FABER/ Figure 4/ Patrick’s test
purpose: SI joint dysfunction or tight hip flexors
pt. pos: supine with ankle crossed above opposite knee, flexion, abduction, and external rotation (FABER)
Prac. pos: standing next to pt. one hand on crossed knee, one hand on opposite asis
procedure: pressure is applied at the knee and asis simultaneously
positive: posterior pain= SI joint dysfunction, anterior pain= tight hip flexors
Thomas test
purpose: tight hip flexors
pt. pos: supine with legs hanging off the table, knees flexed to 90 degrees
Prac. pos: standing next to pt.
procedure: pt is instructed to bring knee to chest and lean back onto table
positive: opposite leg lifts from table flexing at the hip
Pubic symphysis
purpose: ascertain problems in the pubic symphysis or SI joint
pt. pos: supine
Prac. pos: standing next to pt.; heel of hand is moved from the umbilicus to the pubic symphysis
procedure: downward pressure is applied to the pubic symphysis
positive: pain in the pubic symphysis or SI joint, indicating pelvis involvement
piriformis test
purpose: tight piriformis or tibial/ common peroneal nerve (sciatic nerve)
pt. pos: supine
Prac. pos: standing next to pt.
procedure: pt. knee is taken to the opposite shoulder and the foot is then internally rotated
positive: increased pain in the area of the piriformis or any neurological symptoms= nerve involvement
FADIR
purpose: femoral acetabular joint impingement
pt. pos: supine
Prac. pos: standing next to pt. one hand on flexed knee and the other no the ankle of the same leg in a motorcycle grip
procedure: knee is taken into full flexion and moved by the prac. to opposite shoulder. leg is then taken into internal rotation
positive: deep pain, clicking or limited range of motion indicated the necessity of x-ray to confirm diagnosis
babinski test
purpose: neurological deficit or impairment
pt. pos: supine or siting with legs extended
Prac. pos: at foot of pt.
procedure: a finger or hard object is run along the bottom of the foot from first toe to lateral foot towards heel
positive: toes should curl or do nothing. splaying or extension of the toes indicate a positive result
Oppenheim test
purpose: neurological deficit or impairment
pt. pos: supine or sitting
Prac. pos: at foot of pt.
procedure: a finger or hard object is run along the rest of the tibia
positive: same as for babinski. toes should curl or do nothing. splaying or extension of the toes indicate a positive result
milgram’s test
purpose: to determine muscular strain of the low back
pt. pos: supine
Prac. pos: at foot of pt.
procedure: pt is instructed to hold both legs in the air for 30 seconds
positive: inability to perform the procedure due to back pain
Beevor’s sign
purpose: determine the presence of a neurological or muscular disorder of the abdomen/ lumbar spine
pt. pos: supine with hands behind head
Prac. pos: at foot or next to pt.
procedure: have pt perform a sit up
positive: the umbilicus should stay in a straight line. side to side movement is a positive
springing test
purpose: check for hyper or hypo-mobility of an individual vertebrae
pt. pos: prone
Prac. pos: standing next to pt. the pisiform of the hand is placed on the spinous process of each vertebrae sequentially in the lumbar spine
procedure: anterior/ posterior movement in very small increments is initiated with differences noted in movements of each individual segment
positive: a level with extreme motion or lack of motion as compared to other levels
active spinal extension
purpose: to determine muscular involvement of the low back
pt. pos: prone with hands behind the back
Prac. pos: next to pt.
procedure: have the pt. move into active spinal extension
positive: pain with movement or inability to complete maneuver
sphinx position (done after active spinal extension)
purpose: to determine the possibility of a spondy (spondylosis, spondylolisis, spondylolisthesis)
pt. pos: prone with elbows on table
Prac. pos: next to pt.
procedure: have the pt. extend the spine using their arms on the able
positive: pain directly over the spine
spondyloysthesis’s test
purpose: check for spondylolisthesis or slippage of the vertebrae
pt. pos: side lying with both knees flexed
Prac. pos: standing in front of pt. one hand under both knees the other hand on the lumbar spine
procedure: knees are taken into flexion and extension and the lumbar spine is palpated at each vertebral level
positive: vertebrae that does not line up with the others with flexion and extension
Ober’s test
purpose: IT band syndrome
pt. pos: side lying on the table
Prac. pos: standing behind pt. one hand may be placed on the distal leg and the other could stabilize the pelvis
procedure: pt is instructed to let top leg hang over the back of the table
positive: inability to adduct; pain; asymmetry
noble
purpose: IT band syndrome
pt. pos: side lying on table
Prac. pos: standing behind pt. one hand on the distal leg, one thumb on the IT band, 2-4 cm proximal to the knee
procedure: the knee is alternatively flexed and extended while the force is applied with the thumb proximal to the knee
positive: pain, particularly at 30 degrees of flexion
femoral nerve traction test
purpose: determine involvement of the L2-L4 nerve roots or femoral nerve irritation
pt. pos: side lying
Prac. pos: standing behind pt., with top of pt’s foot on hip, one hand on the knee and the other on the PSIS for stabilization
procedure: the knee is passively flexed and the hip extended simultaneously
positive: pain, shooting pain, numbness, tingling
