Ch 13 special tests

Question 1

Valsalva Test

Answer 1

• tests for: space occupying lesion, nerve root pain
• patient: sitting (blowing air into balloon)
• clinician: standing within arms reach in front of patient
• procedure: attempts to duplicate nerve root pain that can be elicited while coughing or with bowel movements
• positive test: increased spinal or radicular pain

Question 2

Straight Leg Raise Test

Answer 2

• tests for: sciatic nerve compression/irritation/impingement, possible disc involvement
• patient: supine
• clinician: one hand under heel, other on anterior knee to keep in full extension
• procedure: keeping knee in extension, raise leg by flexing the hip until discomfort or full ROM obtained (pain <70 degrees = +)
• positive test: pain or reproduction of symptoms before 70 degrees on the leg being tested

Question 3

Well Straight Leg Raise Test

Answer 3

• tests for: large space occupying lesion (herniated disc)
• evaluation procedure same as straight leg raise test
• positive test: pain or reproduction of symptoms on opposite leg than one being tested/raised

Question 4

Slump Test

Answer 4

• tests for: sciatic pain or reproduction of other neurological symptoms (nerve tissue impingement)
• patient: sitting upright
• clinician: at side of patient
• procedure: A) patient slumps forward, cervical spine neutral, apply overpressure to trunk flexion B) pt flexes cervical spine bringing chin to chest C) knee is extended D) ankle dorsiflexed
• positive test: sciatic pain or reproduction of other neurological symptoms
• implications: impingement of the dural lining, spinal cord or nerve roots
• make sure not hamstring pathology by slightly relieving pain with slight flexion of knee and extension of cervical spine then go back to the position, if pain then not hamstrings

Question 5

Femoral Nerve Stretch Test

Answer 5

• tests for: nerve root impingement
• patient: prone
• examiner: at patients side
• procedure: examiner passively flexes patients knee
• positive test: pain is elicited in the anterior & lateral thigh (L2, L3, L4)

Question 6

Single-Leg Stance Test

Answer 6

• tests for: SI joint pathology
• patient: standing
• clinician: standing behind pt
• procedure: pt lifts one leg & puts trunk in hyperextension, clinician may assist, repeat for other leg
• positive test: pain in lumbar spine or SI area

Question 7

Sacroiliac Joint Compression & Distraction Test

Answer 7

• tests for: sacroiliac pathology
  Compression-
• pt: side-laying (painful side up)
• clinician: behind pt with both hands over the lateral aspect of the pelvis
• procedure: apply downward force to compress the anterior SI joint surfaces & puts a tensile force on posterior SI ligaments
  Distraction-
• pt: supine
• clinician: standing next to pt with hands over ill flare
• procedure: apply pressure through anterior portion of ilium compressing the posterior SI joint & placing a tensile force on anterior SI ligament
• positive test for both: pain arising from the SI joint

Question 8

FABER (Patrick) Test

Answer 8

• tests for: hip or sacroiliac pathology
• patient: supine with foot of involved side crossed over opposite thigh
• clinician: at side of pt being tested with on hand on the opposite ASIS & other on medial aspect of flexed knee
• procedure: allow extremity to rest into full external rotation then apply overpressure at the knee & ASIS
• positive test: reproduction of symptoms in the SI joint or hip

Question 9

Gaenslen’s Test

Answer 9

• tests for: SI joint pathology
• patient: supine, laying close to side of table
• clinician: standing at side of pt
• procedure: slide patient close to edge of table, pt pulls knee up to chest, other leg hands over edge of table, stabilize the pt & apply pressure to near leg forcing hip into extension
• positive test: pain in the SI region

Question 10

Sacral Thrust Test

Answer 10

• tests for: SI joint dysfunction or pathology
• patient: lying prone
• clinician: standing next to pt with one hand on top of the other over sacrum
• procedure: apply an anterior force through the sacrum
• positive test: pain in the SI joint