Lumbar Special Tests Flashcards
What is a test that can be used as part of a detailed examination for suspected facet DJD or lateral stenosis?
lumbar Quadrant Test
Prone Knee Bend: Indications for performing test
Radicular pain or signs of peripheral neural tension in the femoral nerve or upper lumbar spine
Prone Bridge: how to perform
Prone (plank) position propped on elbows spaced shoulder width apart; feet narrowly spaced. Stop when pt is unable to hold position.
Norms:
Males: asymptomatic - > 92.9s; symptomatic ->33.4s.
Females: asymptomatic -> 51.2s; symptomatic -> 24.3s
What special test assesses lumbar lateral flexor endurance?
Side Bridge (side plank)
Supine Bridge: how to perform
Supine in a hookline position w/hands positioned by ears. Raise pelvis up so that shoulders, hips, and knees are in straight line. Hold the position. If can hold for 2 min, dominant leg can be extended. Stop when pt is unable to hold position.
Norms:
Males: asymptomatic - > 188s; symptomatic ->77.9s.
Females: asymptomatic -> 152s; symptomatic -> 75.7s
What is a screeing test for lumbar problems?
Lumbar Quadrant Test
Straight Leg Raise: Response & Implications
Response: reproduction of s/s, usually at
Impl: Nerve root impinge or neural tension any LE periph nerves
- local pain reproduced in the 0-30º range may indicate hip dysfunction; pain in the 0-30º range may indicate a highly irritated nerve root
- Pain reproduced in the 30-50º range may indicate sciatic or other nerve involvement
- Posterior thigh pain reproduced in the 50-70ºrange may indicate hamstring involvement or neural tension
What special test assesses lumbar flexor endurance?
Prone Bridge (plank)
Lumbar Quadrant Test: Indications for performing test
Screening test for lumbar problems or part of a detailed examination for suspected facet DJD or lateral stenosis
Prone Bridge: Indications
To assess lumbar flexor endurance
Sorensen: How to perform
pt prone with the superior margin of iliac crests aligned with the ridge of the table.
Stablize the pelvis, knees, and ankles
Extend upper body to the horizontal position and hold until pt is unable to maintain the testing position one time
Norms:
Males: asymptomatic - > 198s; symptomatic ->163s.
Females: asymptomatic -> 197s; symptomatic -> 177s
4 Lower Quarter Neurodynamic Tests
- Straight Leg Raise
- Crossed Straight Leg Raise
- Slump Test
- Prone Knee Bend
Repeated Extension in Standing: How to perform
If first step in series, check flexion ROM before starting
Keep knees straight and extend actively and repeatedly (up to 10 times)
May help if patient puts hands on bottom and slides them down back of legs
What tests are indicated if pt presents with radicular pain or signs of peripheral neural tension in the femoral nerve or upper lumbar spine?
Prone Knee Bend
Prone Knee Bend: How to perform test
pt prone
passivly flex knee until pt feels pain, tightness, or reproduction of symptoms. There is no sensitizing manuver, so PT must ask about quality of sensation to differentiate between nerve and musclular pain/tightness
Response: Reproduction of s/s
Lumbar Quadrant Test: how to perform
pt standing
Passive (assisted) sequential combined extension, LF and rotation (both towards side of pain)
Sorensen: Response & Implications
Response: Stop when pt is unable to hold position.
Norms:
Males: asymptomatic - > 198s; symptomatic ->163s.
Females: asymptomatic -> 5197s; symptomatic -> 177s
Implications: To assess the endurance of the lumbar extensors and determine whether lumbar extensor strengthening is warranted in a treatment program
What tests are indicated if pt has radicular s/s in one LE?
Crossed Straight Leg Raise
Repeated Flexion in Testing: Response & Implications
Response:
- (+) if local or distal sumptoms peripheralize
- if symptoms centralize, it suggests and anterior disc derangemnt but this should be correlated with repeated extension
- If (+) then extension mobility will often be reduced afterward
Implications:
- If symptoms peripheraize (+), suspect a posterior disc derangement
- If symptoms centralize, suspect an anterior derangement
2 General Lumbar Special Tests
- Prone Instability Test
- Lumbar Quadrant Test
What special test is indicated if pt has redicular s/s in one LE?
Crossed Straight Leg Raise
Prone Instability Test: Indications for performing test
Central lumbar pain with or without radicular s/s