Lower Quarter Special Tests and Screening Flashcards
Assessment Skills
Describe the technique and interpretation of the Prone Instability Test.
Lower Quarter Special Tests and Screening
With the patient prone on table and holding the sides of table (legs over edge), the therapist provides posterior-to-anterior pressure over the lumbar spine. If pain is provoked, the patient lifts their legs and the posterior-to-anterior pressure is repeated. If no pain, the test is positive for segmental instability.
Assessment Skills
Describe the technique and interpretation of the Straight Leg Raise Test.
Lower Quarter Special Tests and Screening
(The therapist should assess the non-involved leg first.) With the patient in supine, the therapist places one hand on the knee and one on the ankle and raises the patient’s leg (Lasegue’s Test). The therapist can add ankle dorsiflexion (Bragard’s Sign) or cervical flexion. If dorsiflexion makes the symptoms worse, the symptoms are likely neural and worsened by tension. If cervical flexion makes the symptoms better, the symptoms are likely neural and worsened by distal neural mobility.
Variations Include:
Crossed (Well-leg) raise test - a straight leg raise of the contralateral side that indicates profound central disc injury that should be treated with traction.
Active Straight Leg Raise to 90° - a straight leg raise test to check for mobility of the lower extremity. A result beyond 90° is indicative of lumbar hypermobility and suggests that treatment should include stability exercise.
Men’s Active Straight Leg Raise - a low straight leg raise to only 20cm off the table that looks for weakness in those with pelvic ring dysfunction. If adding bracing at the pelvic ring (manual or belt) improves the subjective ease of the test, belting and pelvic stability training is indicated.
Assessment Skills
Describe the technique and interpretation of the Slump Test.
Lower Quarter Special Tests and Screening
With the patient sitting at th edge of the table, the therapist asks the patient to slump and the therapists arm goes to the patient’s thoracic spine. The following steps are performed:
1. Add active cervical flexion and maintain this position with the therapist’s hand.
2. Add active/passive knee extension of the involved leg
3. Add passive ankle dorsiflexion
4. Add active neck extension
If knee extension or dorsiflexion makes the symptoms worse, this indicates the symptoms are of sciatic origin. If neck extension relieves the patient’s symptoms, the neural involvement is irritated by tension. If neck extension worsens symptoms, the neural involvement is irritated by distal mobility.
Assessment Skills
Describe the technique and interpretation of the Hamstring Passive Length 90/90 Test.
Lower Quarter Special Tests and Screening
With the patient in supine and their hip flexed to approximately 90°. The therapist passively extends lower leg and measures the knee angle with the same landmarks as knee flexion. Normal = 75° of knee extension measured using 90° of knee flexion as the starting point.
Assessment Skills
Describe the technique and interpretation of the Thomas Test.
Lower Quarter Special Tests and Screening
With the patient sitting on the edge of the table, the therapist asks the patient to lower one leg as the therapist assess if the patient’s thigh touches the table. IF NOT, the therapist extends the knee. If the thigh still does not touch, there is tightness of iliopsoas. If thigh does touch, there is tightness of rectus femoris. PT can measure hip angle OR knee angle using same landmarks as with goni. Normal = 0° hip flexion, 80° knee flexion.
The therapist can also look to see if the patient stays in the sagittal plane. Deviation medially or laterally indicates adductor or TFL tightness, respectively.
Assessment Skills
Describe the technique and interpretation of the Apparent Leg Length Difference Test.
Lower Quarter Special Tests and Screening
With the patient in supine, the therapist measures from umbilicus to medial malleoli on both legs and compares the measurements.
Assessment Skills
Describe the technique and interpretation of the Craig’s Test.
Lower Quarter Special Tests and Screening
With the patient prone and their knee bent to 90°, the patient passively IR/ERs the femur to find where greater trochanter is most prominent, then measures the position of the tibia. The tationary arm is parallel to table, with the moving arm along the anterior midline of the tibia.
Normal = 10-15° tibial ER
Anteversion = greater than 15°
Retroversion = less than 10°
Assessment Skills
Describe the technique and interpretation of the Ober’s Test.
Lower Quarter Special Tests and Screening
With the patient in sidelying with the involved leg up, the therapist stands behind the patient and agressively stabilizes the pelvis to prevent tilt/rotation. The therapist abducts/extends the patient’s hip and flexes the patient’s knee approx 20° to assume the starting position. Then the therapist passively adducts while still stabilizing the pelvis.
Normal = 10° below horizontal
Assessment Skills
Describe the technique and interpretation of the
Lower Quarter Special Tests and Screening
Assessment Skills
Describe the technique and interpretation of the
Lower Quarter Special Tests and Screening
Assessment Skills
Describe the technique and interpretation of the
Lower Quarter Special Tests and Screening
Assessment Skills
Describe the technique and interpretation of the
Lower Quarter Special Tests and Screening
Assessment Skills
Describe the technique and interpretation of the
Lower Quarter Special Tests and Screening
Assessment Skills
Describe the technique and interpretation of the
Lower Quarter Special Tests and Screening
Assessment Skills
Describe the technique and interpretation of the
Lower Quarter Special Tests and Screening
