Lower Eval Week 2

Question 1

What does screening do?

Answer 1

Begins to rule out many possible diagnoses

Question 2

Reliability

Answer 2

Extent a test is free from error, uses the intraclass correlation coefficient

Question 3

Intrarater reliability

Answer 3

Reliable for a single person

Question 4

Interater reliability

Answer 4

Reliable for a group

Question 5

Dichotomous Outcomes

Answer 5

Either positive or negative that the patient has the pathology

Question 6

What value is used to adjust for chance in dichotomous outcomes

Answer 6

Kappa value

Question 7

Validity

Answer 7

The test is actually testing what you want tested

Question 8

QUADAS

Answer 8

Quality Assessment of Diagnostic Accuracy Studies

Question 9

Specificity

Answer 9

Fraction of people without the disease that got a negative test
Highly specific tests will not give many false positives

Question 10

SPIN

Answer 10

Specificity rules in a diagnosis

Question 11

Sensitivity

Answer 11

Fraction of people with the disease that got a positive result
Highly sensitive tests will identify nearly everyone with the disease

Question 12

SNOUT

Answer 12

A test with a high sensitivity that is negative will rule out a diagnosis

Question 13

Likelihood Ratio

Answer 13

Index developed to describe how reliably a test detects a condition

Question 14

Calculations of Likelihood Ratios

Answer 14

LR+ = Sensitivity/(1-Specificity)
LR- = (1-Sensitivity)/Specificity

Question 15

To rule IN a disorder

Answer 15

Want a high LR+

Question 16

When you want to rule OUT a disorder

Answer 16

A low LR-

Question 17

What does LR of 1 mean?

Answer 17

Gives no information one way or the other

Question 18

Utility Scores

Answer 18

1. Evidence strongly supports the use of the test
2. Evidence moderately supports the use of this test
3. Evidence minimally supports the use of this test
   ? This test has not been sufficiently researched to determine its value

Question 19

Lower Extremity Screening

Answer 19

Check static, gait, palpatory landmarks, ASIS, sacral sulcus, inferior lateral angle of sacrum, ischial tuberosities, sacrotuberous ligament, PSIS, sacral base, long dorsal ligament, pubic tubercles, functional procedures, hop, lower extremity motion screen, spinal side bend, standing forward flexion test, seated flexion test, stork test, relative leg-length test, prone motion, sphinx position, supine motion, Lasegue’s test- SLR

Question 20

Static

Answer 20

Check standing posture from the front, behind, and at each side

Question 21

Gait

Answer 21

Check gait from AP and lateral view, check functional capacity, cross patterning of the gait and symmetry of stride, check for pes planus/cavus

Question 22

Palpatory Landmarks

Answer 22

Rib angles, iliac crests, greater trochanters

Question 23

ASIS

Answer 23

Look for level and in-leveled

Question 24

Functional Procedures

Answer 24

C-spine and upper thoracic, upper extremity motion screen, thoracic cage (smooth and symmetrical during inhalation and exhalation), lumbar spine

Question 25

Lower Extremity Motion Screen

Answer 25

Squat Test

Question 26

Spinal Side Bend

Answer 26

Looking for symmetry of tissue T1-L5 and a symmetrical C-shaped curve in both directions, a positive test includes a straitening of segments of the c-curve on the side of the concavity

Question 27

Standing Forward Flexion Test

Answer 27

Thumbs move caudal and lateral, asymmetrical motion is the side that moves toward the head first or farthest is the restricted side if stuck with the sacrum or has an innominate rotation or symphysis problem

Question 28

Seated Flexion Test

Answer 28

Asymmetrical motion is the side that moves toward the head first or farthest is the restricted side, if seated is positive do sacral tests

Question 29

Stork Test

Answer 29

Identifies SI and TJ dysfunction, normal is PSIS drops inferiorly and moves laterally on lifted leg, abnormal there is no motion or moves up on lifted leg

Question 30

Relative leg-length test

Answer 30

Standing and seated

Question 31

Prone Motion

Answer 31

Thoraco-lumbar junction motion and lumbo-sacral junction motion

Question 32

Supine Motion

Answer 32

Hamstring tension test, relative leg-length difference, Lasegue’s test, single leg with pain with PROM beyond 70º indicates joint pathology, same with double leg indicates SI pathology