Lab Midterm Flashcards
how long is a sustained mob held for?
at least 6 sec
the mobilizing arm should be _____ to the line of force and ____ to the joint
parallel - force
perpendicular - joint
when is SLR positive?
reproduction of sx between 30-70 deg
SLR to bias tibial nerve
DF, eversion, toe extension
SLR to bias sural nerve
DF, inversion
SLR to bias common fibular nerve
PF, inversion
common with lateral ankle sprains
neurodynamic mobilization techniques
tension
gliding
stretching (hold at tension)
neurodynamic mobilization contras
recent repaired or injured peripheral nerve
malignancy
active inflammatory conditions
acute inflammatory demyelinating disease
what is short and what is weak with a flattened spine posture?
short hamstrings
weak hip flexors
what is short and what is weak with excessive lordosis posture?
short ES and hip flexors
weak core and hip extensors
lumbar exam
double limb squat
SLS
demo lift, bend, twist
L spine AROM & resisted testing
LE ROM (T spine & hip)
MMT
Neuro
endurance
flexibility
nuerodynamic
joint play
prone instability test (if indicated)
stoop test (if indicated)
Waddell’s test (if indicated)
if lumbar AROM is painful, how is resisted tested?
in neutral
grades of Sorenson test
5 - normal; hands behind head, hold 20 sec
4 - hands at side, 15-20 sec hold, lift ribs
3 - hands at side, 10-15 sec hold, lift sternum
2 - hands at side, 1-10 sec hold, lift head
what is the max time for Sorenson?
4 mins
dynamic abdominal endurance test grades
5 - hands behind neck, scap clear, 20-30 sec
4 - arms crossed chest, scap clear, 15 sec
3 - arms straight, scap clear, 10-15 sec
2 - arms extended, scap lifts, 1-15 sec
1 - trace
how long is contraction held for neuro testing of a myotome?
5 sec
when are reps done for myotome testing?
if pt involved is at that level but not fatiguing with initial 5 sec hold
what myotome does toe walking assess?
S1-S2
walk away from PT
what myotome does heel walking assess?
L4
walk towards PT
SLR positive finding
concordant sx in 30-70 deg
what is the treatment if positive Well/Crossed leg SLR?
traction
positive finding for prone knee bend test (femoral nerve)
sx reproduced b/w 80-100 deg knee flex
reproduction of sx >80 for prone knee bend test (femoral nerve)
joint dysfunction
reproduction of sx >100 for prone knee bend test (femoral nerve)
tightness
when would PT do prone knee bend test (femoral nerve)?
anterior pain
(trauma, lack of extension, pregnancy, obesity)
order of joint play for spine
Do CPAs 1st then can do UPAs if can’t recreate pain
positive prone instability test
decrease pain with mm activation
positive stoop test
vascular sx improve with stooped posture
positive Waddell’s test
≥3/5 of criteria met
5 criteria for Waddell’s
stimulation
regional
tenderness
distraction
over-reaction
CPR for manual therapy
no sx distal to knee
<16 days onset
<19 on FABQ-W
at least 1 hypomobile
at least 1 hip >35 deg IR
CPR for stabilization
<40 yo
post-partum
average SLR >91
instability catch
+ prone instability test
postpartum CPR for stabilization
+ pelvic pain provocation, ASLR, and modified Trendelenburg
OR
pain with palpation of long dorsal SI lig or pubic symphysis
benefits of manipulations
mobility, increase ROM, proprioception, decrease pain, decrease pressure, decrease hypertonicity
which region is the million dollar (Chicago) roll for?
lower L spine & upper sacral
which way to discs usually herniate?
posterolateral –> shift away
tx rx for lateral shift
10-20 times/hr while awake
tx rx for extension preference
20 times/hr while awake
tx rx for flexion preference
6-10 times/hr while awake
what observation is different with lumbar + SI exam?
transitional movements (sit<>stand, sit <> supine)
if any of these are +, then an SI exam is added
Fortin’s sign
primary SIJ stress test
TTP at posterior SI ligaments
pain/weakness with SLS
CPR for + SIJ dysfunction
compression
distraction
sacral thrust
Gaeslen test
thigh thrust
≥ 3 +
CPR for - SIJ dysfunction
compression
distraction
Gaeslen test
FABER
thigh thrust
≤ 3 +
sensitivity and specificity for + SIJ CPR
sensitivity - 0.91
specificity - 0.87
sensitivity and specificity for - SIJ CPR
sensitivity - 0.85
specificity - 0.79
what does a positive sign of buttock mean?
serious pathology:
neoplasm
fracture
infection
septic arthritis
when is the seated flexion test done for SI?
confirmed SIJ probs with CPR, hypomobility, and palpation asymmetries
what is the seated flexion test used to rule out?
LE dysfunction such as LLD or hamstring tightness when compared to standing test
positive test for seated and standing flexion test
PSIS do not move equal distances w/ affected side moving more than unaffected side
how is the pelvis positioned when a limb is longer with the long sitting test?
posterior innominate
how is the pelvis positioned when a limb is shorter with the long sitting test?
anterior innominate
which leg is tested with the Stork test (Gillet’s)?
standing leg
where to palpate on the Stork test (Gillet’s)?
PSIS and base of sacrum
positive test for the Stork test (Gillet’s)
PSIS does not move inferiorly when compared to sacrum OR causes concordant SI joint pain
the million dollar (Chicago) roll may be used for _____ innominate
anteriorly rotated
what position is the LE in the long axis traction (prone) technique (SI)?
slight abduction
extension
slight IR
which structure is mobilized for counternutated sacrum?
base
which structure is mobilized for nutated sacrum?
apex
what is the prone SIJ mobilization used to restore?
anterior innominate rotation
what position is the hip in the prone SIJ mobilization?
extension (held by PT)
