Special Tests Flashcards

1
Q

Functional Opening “Knuckle” Test

A

TMD

Functional Opening “Knuckle Test”
- Patient is instructed to place 2 flexed PIP joints w/in thier mouth
(+): Inability to fit 2 PIP joints w/in their open mouth

Functional Opening = 2 PIP w/in mouth
Maximal Opening = 3 PIP w/in mouth

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2
Q

Spurling’s (Foraminal Compression) Test

A

Cervical Radiculopathy

Therapist applies a axial load by pressing straight down on patient’s head

If no symptoms occur whille head is in neutral progress to:
1. Extension + rotation to unaffected side, then extension + rotation to affected side
Closing the IVF down even more
2. Side flexion to affected side - contralateral (may alleviated S/S slightly)

(+) = reproduction of radicular symptoms (towrds the side of side flexion)

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3
Q

Cervical Distratction

A

Cervical Radiculopathy

Test is used when a patient is currently experiencing radicular symptoms

PT places one hand under the chin & the other hand around the occiput, lifts upward to apply a traction to the c-spine

(+): Radicular symptoms decreased or abolished

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4
Q

Vertebral Artery (Cervical Quadrant) Test

A
  • Patient is positioned in supine
  • Therapist passively takes patients head & neck into extension & side flexion & holds for 10-30 seconds

If no symptoms are produced, ipsilateral neck rotation is added & posiiton is held for 10-30 seconds

** EYES OPEN thoughout test

(+) = Dizziness or nystagmus. This indicates that the contralateral side artery is being compressed
- Tensioned & getting compressed as it passes through the canal

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5
Q

Anterior Shear or Saggital Shear Test

A

Cervical Instability

Tests the integrity of supporting anterior ligaments & capsular tissues

Procedure:
- Patient in supine, head in neutral
- Therapist stabilizes the vertebra by placing both thumbs over the anterior aspect of the TPs
- Therapist applies an anterior force on the adjacent vertebra above the stabilized vertebra
May apply force through SP or bilaterally through the posterior arch (lamina)

(+) = Excessive motion &/or S/S of cervical instability

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6
Q

Lateral Flexion Alar Ligament Stress Test

A

Cervical Instability

Tests the integrity of the contralateral alar ligament

Procedure:
- Patient in supine, head in neutral
- PT stabilizes C2 with wide pinch grip around SP & lamiina
- PT side flexes C1 & head

(+) = excessive side flexion
An intact alar ligament results in a strong capsular end-feel

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7
Q

Lateral (Transverse) Shear Test

A

Cervical Instability

Tests the integrity of lateral ligaments & capsular tissue

Procedure:
- Patient in supine, head in neutral
- Forwarn patient that test may cause pain and discomfort **
- PT places the radial aspect of the 2nd MTP joint of one hand aginst the TP of one vertebra & the radial aspect of the 2nd MTP joint of the other hand on the TP of an adjacent vertebrae on the other side of the neck
- PT hands are then pushed together carefully creating a shearing force of one vertebra over the other

(+) = Excessive motion or sumptoms of instability, spinal cord, or vascular pathology
- Minimal motion and no symptoms should be produced with intact ligaments & capsular tissue

NEED to refer patient - at risk for numerous adverse events (stroke)

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8
Q

Sharp-Purser Test

A

Cervical Instability

Should be performed with extreme caution

Test to determine subluxation of C1 (atlas) on C2 (axis)
- Transverse ligament helps maintain position of the odontoid process of C2 relative to C1. If the transverse ligament is torn, C1 will sub lux by translating forward relative to C2 in flexion
- Patient may be hesitant or reluctant to perform forward flexion

Procedure:
- PT places one hand over the patient’s forehead & the thumb of the other hand is placed over the C2 SP in order to stabilize C2.
- Patient is asked to slowly flex head forward, while the PT applied pressure against the patient’s forehead. May hear a clunk - could possible reduce the subluxation

(+) = PT feels the head slide backwards during the movement
- Indicates relocation of subluxed atlas. May be accompanied by a clunk

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9
Q

Cervical Flexion-Rotation Test

A

Cervical Instability

Indicates C1-C2 dysfunction
Validated as a diagnostic test for C1-2 related CERVICOGENIC headache

Procedure:
- Patient in supine
- PT fully flexes the patient’s c-spine (chin-chest) & proceeds to rotate the patient’s head to the RT & LT (while maintaining full c-spine flexion) to assess ROM
FULL FLEX: locks C3-7) to evaluate how much rotation is at C1-2

(+) =
- Increased or decreased ROM 45 degrees upper c-spine rotation ROM indicating a C1-2 dysfunction
- Reproduction of headache indicating C1-2 cervicogenic headache

False (+) if you do not lock the pt C/S well

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10
Q

Craniocervical Flexion Test (Pressure Feedback Test)

(+) = 4

A

Segmental Instability - Clinical Instability

Procedure:
- Test deep neck flexor mm function
- Patient positioned in supine in crook-lying with c-spine in neutral (place towels under head to achieve neutral c-spine if necessary)
- Place inflatable pressure sense (BP cuff) under the upper c-spine
- Inflate pressure device to a base level of 20 mmHg
- Instruct the patient to perform upper c-spine flexion by nodding the head slowly & gently in order to reach a pressure grade of 22 mmHg & hold for 10 seconds
If activation of SCM occurs = pt is doing it wrong
- This is repeated at increasing pressure grades (22, 24, 26, 28, and 30)
- Most young & middle-aged patients can successfully perform test at 26 & hold for 10 seconds

(+) =
- Patient is unable to increase pressure to at least 26 mm Hg
- Unable to hold contraction at given pressure for 10 secs (or it teeters)
- Inability to raise pressure in small increments (2 mm Hg)
- Uses compensatory patterns:
Uses superficial neck mm (SCM)
Extends the head
*Overactivity of global mm & underactivity of deep mm

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11
Q

Adams Test
(Adams Forward Bend Test)

A

Scoliosis

Procedure:
- The patient takes off his/her t-shirt so that the spine is visible.
- The patient needs to bend forward, starting at the waist until the back comes in the horizontal plane, with the feet together, arms hanging and the knees in extension. The palms are held together.
- The examiner stands at the back of the patient and looks along the horizontal plane of the spine, searching for abnormalities of the spinal curve, like increased or decreased lordosis/ kyphosis, and an asymmetry of the trunk

(+) = indicated if asymmetry is observed (one side of the spine is higher than the other)

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12
Q

SLUMP

A

Lumbar Radiculopathy

Patient in sitting w/ legs unsupported

Procedure:
- PT instructs the patient to place hands behind back, go into slump posture (rounded shoulders) bringing thier chin to their chest
- PT passively extends the uninvolved knee then repeats the test on the involved side
- If symptoms have not been reproduced ankle DF is added
- If symptoms of low back pain/ radiating pain in posterior leg are recreated, ask patient to extend their neck while maintaining a rounded back

(+) =
- relief of symptoms when patient extends neck indicates neural tension/restriction of lumbosacral roots
- It can also be interpreted as a restriction of the dura/neural tissues
- If symptoms are reproduced at any stage futher sequential movements are not attempted

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13
Q

Straight Leg Raise (SLR)

A

Lumbar Radiculopathy

Patient lying in supine
Test unaffected side first

Procedure:
- PT slightly adducts & medially rotates patient’s hip, keeping the knee in full extension
- PT flexes patient’s hip (w/ knee in full extension) until the patient indicates pain or rightness in posterior thigh
- Therapist slowly lowers leg slightly until pain or tightness disappears
- PT dorsiflexes the foot or alternately asks the patient to flex their neck to verify if are symptoms reproduced

ROM explained:
- Before 35 degree nerve slack bring taken up
- At 35 root is under tension
- At 60-70 sciatic roots tense over disc
- > 70 degree pain is likely MSK (hamstring stretch)

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14
Q

Sign of the Buttock

A

Procedure:
- the PT performs a SLR until the point of restriction
- The PT proceeds to flex the knee to see whether an increase in hip flexion may be achieved

(+) =
- Hip flexion does NOT increase when the knee is flexed
- Indicates pathology behind the hip joint in the buttocks
Ex. bursitis, tumor, or abscess

REFERRAL - could be something sinister

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15
Q

Bow-String Test

A

Lumbar Radiculopathy

Follows a positive SLR
- While maintaining the SLR position which reproduced symptoms, the PT slightly flexes (20 degrees) the patient’s knee to reduce symptoms

Procedure:
- The PT then puts pressure into the popliteal area using his/her thumbs or fingers

(+) = Reproduction of radicular symptoms
Indicates pressure or tension on sciatic nerve

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16
Q

Quadrant (Extension Quadrant) Test
(Kemp’s Test)

A

L/S Facet Syndrome

Patient standing upright with PT standing behind patient

Procedure:
- Patient extends the L/S, and side flexes & rotates to the side of pain
- Overpressure is applied into extension by the OT

(+) = reproduction of symptoms (low back pain) may indicate facet joint involvement

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17
Q

Special Test: H & I Stability Test

A

L/S Clinical Instability - Set of movements which tests for mm spasms or possible spinal instability

Procedure:

“H” movement:
- The patient begins in neutral standing position
- the patient is asked to perform side flexion as far as possible (both are tested, start w/ pain-free direction first)
- The patient is then asked to perform flexion or extension as far as possible (both are tested, start with pain-free direction first)
- Repeat with side flexion to other side

“I” movement
- The patient begins in neutral standing position
- The patient is asked to perform lumbar flexion OR extension as far as possible (both are tested, start with pain-free direction first)
- The patient is then asked to perform side flexion to one side as far as possible (both are tested, start with pain-free direction first)
- Repeated with side flexion to other side

(+) =
Hypomobility
- At least 2 movements limited or painful in the SAME quadrant

Instability
- Only 1 movement into the quadrant is affected (may present with pain or instability “jog” > one moment when you feel instability & get pain in that moment BUT after you go past that you are good
- The direction of instability is the movement that is performed in the first phase of movement
- If the movement is performed in the second phase of movement it can be stabilized by the first movement & an instability would not be apparent

** IF “H” or “I” is painful & there other is not = INSTABILITY

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18
Q

Prone Segmental Instability Test

A

Position:
Patient lies with their upper body prone on the examination table while their legs are over the edge of the table resting on the floor

Procedure:
- PT applied PA pressure on the L/S
- The patient is instructed to lift their legs off the floor

(+) = pain is produced while the legs are resting on the floor, but not present when the legs are lifted off the floor
- Test indicates patient would benefit from core strengthening/stability exercises

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19
Q

Adson Manuever
Costoclavicular Syndrome (Military Brace) Test
Halstead Manuever
Wright Test
Allen Test

A

TOS

All tests palpate RADIAL pulse in different postures
(+) = if radial pulse disappears

Arterial type TOS

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20
Q

Adson’s test OR Manuever

A

Compression of the subclavian artery by a cervical rib or tightened anterior and middle scalene muscles

The test can be performed with the patient in either sitting or standing with their elbow in full extension

Procedure
- The arm of the standing (or seated) patient is abducted 30 degrees at the shoulder and maximally extended.
- The radial pulse is palpated and the examiner grasps the patient’s wrist.
- The patient then extends the neck and turns the head toward the symptomatic shoulder and is asked to take a deep breath and hold it.
- The quality of the radial pulse is evaluated in comparison to the pulse taken while the arm is resting at the patient’s side.
- Some clinicians have patients turn their head away from the side tested in a modified test.

(+) = marked decrease, or disappearance, of the radial pulse. It is important to check the patient’s radial pulse on the other arm to recognize the patient’s normal pulse.

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21
Q

Costoclavicular Syndrome ( OR Military Brace OR Eden’s) Test

A

TOS

Procedure:
- Patient is standing.
- The examiner palpates the radial pulse and then draws the patient’s shoulders down and back as the patient lifts their chest in an exaggerated “at attention” posture

(+) =
1. An absence or decrease in vigor of the pulse and implies possible costoclavicular syndrome
2. Also positive if the client experiences an increase of neurologic symptoms into the upper extremity on that side

This test is particularly effective in patients who complain of symptoms while wearing a backpack or heavycoat

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22
Q

Halstead Manuever

A

TOS

Procedure:
- The patient is sitting or standing. - The therapist continuously palpates the radial pulse on the side being tested.
- While still palpating the radial pulse, the therapist abducts the arm to 45 degrees, extends the shoulder to 45 degrees, and externally rotates the upper extremity while applying a downward distraction to the arm. - The patient is then asked to fully turn her head away from the side being tested and extend the cervical spine.

(+) = Disappearance or decreasing of the radial pulse

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23
Q

Wright Test (Hyper-Abduction test)

A

TOS - thought to implicate the axillary interval (space posterior to pectoralis minor)

The test is performed in the sitting and then in a the supine positions

Procedure:
the test is performed in 2steps

First step:
- Head forward, while the arm is passively brought into abduction and external rotation to 90 without tilting the head.
The elbow is flexed no more than 45. The arm is then held for 1 min
- The tester measure radial pulse and monitor patient symptoms onset

  1. Seconed step:
    - The tester monitors the patient’s symptom onset and the quality of the radial pulse.
    - The test is repeated with extremity in hyperabduction (end range of abduction)

(+) = decrease in the radial pulse and/or reproduction of the patient’s symptoms

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24
Q

Roos Test (Elevated Arm Stress Test)

A

TOS
Procedure:
PT open & closes fists with shoulder (horizontal abduction) & elbow at 90 degrees for 3 minutes

(+) = inability to hold position for 3 mins
- Ischemic pain - arterial
- Heaviness/weakness = arterial
- S/S of neurological weakness - ex. numbness & tingling

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25
Shoulder Girdle Passive Elevation (Cyriax Release Test)
Procedure: - Pt crosses arms & PT lifts elbows up - elevation (+) = relieves neurological S/S - Skin colour changes / temp - arterial - Pulse becomes stronger - Less cyanotic - venous Cyriax = switch arm positions: pt has elbows @ 90 & pronated & PT lifts the arms this way
26
Special Test: Cross Body (Horizontal) Adduction Test
Shoulder Separation - The test is performed by passively bringing the patient's arm into 90 degrees of forward flexion, with their elbow also flexed to 90 degrees. - The examiner then horizontally adducts the flexed arm across the patient's body, bringing their elbow towards the contralateral shoulder (+) = if the maneuver successfully reproduces the patient's symptoms of pain localized over the AC joint
27
Crank (apprehension) & relocation test Apprehension release (suprise) test Load & shift test
Anterior Instability
28
Crank (apprehension) & relocation test
Jobe Relocation Test (also referred to as the Fowler Sign) is to test for anterior instability of the glenohumeral joint. - **often administered after the Apprehension Test** Position: - The patient is positioned supine, with the elbow flexed to 90 degrees and abducted to 90 degrees Procedure: - The therapist then applies an external rotation force to the shoulder, - **If** the patient reports apprehension in any way, the Apprehension Test is considered to be positive. - At this point, the therapist may apply a posteriorly directed force to the shoulder - **If** the patient's apprehension or pain is reduced in this position, the Jobe Relocation Test is considered to be positive
29
Apprehension release (Surprise) test
Before you can use the release or surprise test the patient has to have had apprehension during the apprehension test that was reduced during at AP glide of the relocation test. The “surprise” comes from spontaneously releasing the Anterior-posterior directed pressure on the glenohumeral joint. This should result in re-elicitation of the patient’s fear of luxation and indicates a positive test. Be careful to not bring the arm into further external rotation or horizontal abduction while releasing as you may risk anterior luxation!
30
Load & shift test
Anterior &/or Posterior Instability Procedure: - To perform the test have your patient in sitting position with his arm resting on the thigh, a straight posture, and relaxed muscles. - Stabilize the clavicle and scapula with one hand and grab the head of the humerus with your other hand and bring it into the normal position relative to the glenoid. - With many patients, the head of the humerus will rather be positioned a bit **anteriorly**. - During the **load** **portion** of the test, push the head of the humerus anteriorly in order to test for anterior laxity and posteriorly for posterior laxity. (+) = reproduce the patient’s symptoms and if the tested side clearly translates further than the other side.
31
Jerk Test Load & shift test Posterior Apprehension
Posterior Instability
32
Jerk test
Postero-inferior instability of the Glenohumeral joint. Procedure: - While stabilizing the patient’s scapula with one hand and holding the affected arm at 90° abduction and internal rotation - Examiner grasps the elbow and axially loads the humerus in a proximal direction. - The arm is moved horizontally across the body. (+) = indicated by a sudden clunk as the humeral head slides off the back of the glenoid. - When the arm is returned to the original position, a second jerk may be observed, that of the humeral head returning to the glenoid.
33
Posterior Apprehension
Posterior instability - To test for posterior glenohumeral capsular laxity and/ or posterior labrum. Procedure: - The examiner places the tested arm in 90 degrees shoulder flexion, neutral rotation, and 100-105 degrees of horizontal adduction. - Next, the examiner places their other hand underneath the patient's scapula for support & applies a force through the long axis of the humerus. - Assess the patient's response (+) = long axis force reproduces a sense of apprehension and increased muscle guarding to prevent posterior shoulder dislocation
34
Suclus sign Feagin Test
Inferior & multidirectional instability
35
Feagin Test (Inferior Drawer Test)
Check the inferior shoulder stability.It assesses humeral head inferior subluxation Patient position: The patient is tested best when relaxed in the sitting position beside the clinician. Patient will be in either sitting or standing position. Examiner position: The clinician holds the patient's upper extremity at 90 degrees of abduction, with the patient's forearm over the clinician's shoulder and elbow extended. Technique: The clinician uses one hand to apply an inferiorly and slightly anteriorly directed force while the other hand palpates the edge of the acromion and the humeral head to feel for displacement anteriorly and inferiorly. (+) = a sense of apprehension, pain, or an increased amount of translation in the **inferior** direction (anteroinferior instability)
36
Clunk Test Active Compression Test of O'Brien (specifc to..) Biceps Load Test (Kim Test II)
Glenohumeral Labral Tear ​ Active Compression Test of O'Brien - specific to SLAP tear
37
Hawkins Kennedy Impingement Test Neer's Impingment Scapular Assist Test
Subacromial Impingment Syndrome Hawkins Kennedy Impingement Test - IR arm in front of pt > placing the greater tubercle into the narrow aspect of the subacromial arch where it compresses the other structures (+) = pain Neer's Impingement Test: - PT places arm into IR (0 degree elbow ext) & passively flexes arm in scapular plane - Bring the greater tubercle towards the narrow aspect of the subacromial arch SO compression happens earlier & more (+) = pain Scapular Assist - ABD & PT helps facilitate the mvmt (+) = decrease of pain
38
Speed's Test Yergason's test
Biceps (LHB) Yergason's - not specific for tendinitis - rather assess the ligament holding the LHB tendon
39
Drop Arm Test "Empty" Can Test
Supraspinatus Drop Arm Test (TEAR): lifting pt arm passively & tell them to hold this position & let go && they can NOT hold the position "Empty can" Test - pathology
40
Belly Press Test Lift-off sign Internal Rotation Lag Sign
Subscapularis
41
Infraspinatus Test Lateral Rotation Lag sign
Infraspinatus
42
Hornblower's Sign
Teres Minor
43
Wall or Floor Push Up Test Scapular Load Test Punch Out Test
Scapular Dyskinesia - Scapular Winging Wall or Floor Push Up Test (wall = greater load) Scapular Load Test - wt or manual resisting @ 45 of ABD ** Looking at scapula when doing the test. Punch Out Test - making a fist w/ straight elbow & resisting protraction
44
Valgus Stress Test | Elbow
UCL Tear 0, 20-30 degrees 20-30 - limits stretch of joint capsule - really biasing the ligament
45
Cozen's Test
Lateral Epicondylosis Method 1 Resisted wrist extension (+) = if it provokes pain
46
Mill's Test
Lateral Epicondylosis Method 2 Passive wrist flexion (stretching of wrist extensors) (+) = if it provokes pain
47
Maudsley's Test
Lateral Epicondylosis Method 3 Resisted 3rd digit extension (+) = if it provokes pain
48
Medial Epicondylitis (Golfer's Elbow) Test **Reverse Mills Test**
Medial Epicondylosis Stretching wrist flexors (+) = if it produces pain
49
Not Special Test: Medial Epicondylosis | 2
Resisted Wrist Flexion Resisted Pronation
50
Cubital Tunnel Compression Test
PT applies pressure over the area (tunnel) (+) = pain &/or paraesthia
51
Tinnels Test at elbow
Cubital Tunnel Syndrome PT taps over the cubital tunnel (+) = pain &/or parethesia
52
Elbow Flexion Test
Cubital Tunnel Syndrome Ulnar nerve is stretching around the tunnel & flexion causes it to stretch even more ULTT - similar BUT askin gthe pt to hold it (+) = pain & reproduction of symptoms
53
Finkestein Test
Place thumb into closed fist & actively UD (+) = pain
54
TFCC Load Test (Sharpey's Test)
TFCC tear Procedure: - Grab forearm & hand - apply a compressive load through wrist - Placing pt in UD & move into different positions (EXT > FLEX) (+) = pain or hear a click
55
Press Test
TFCC Tear Procedure: - pt pushes up from a chair ("dip") (+) = pain
56
Tinel's Test
CTS
57
Phalen's Test
CTS
58
Reverse Phalen's Test
CTS
59
Carpal Compression Test
CTS
60
Resisted APB
CTS
61
Froment's Sign
UTS
62
Guyon Canal Compression Test
CTS
63
Tinel's Test (over Guyon's canal)
UTS
64
Thumb UCL Laxity or Instability Test
UCL Sprain Valgus stress test (Gr.1-3)
65
Grind Test
Thumb Carpometacarpal Osteoarthritis Axial compressionn while rotating (+) = pain
66
Scour Test
Not specific for hip OA rather a hip pathology PT: flexion + add/abduction - moving femur on different surfaces of acetabulum (+) = pain, spasm - "catch" feel resistance & moving over it
67
Patrick's (FABER) Test
Not specific for hip OA rather a hip pathology "Figure 4" position (+) = if ROM is limited & knee is not dropping down to parallel or lower *Also part of cluster test for SI pain
68
Flexion-Adduction (Hip Quadrant) Test
Not specific for hip OA rather a hip pathology Looking for pain or discomfort NOT scouing - just going into both mvmt (+) = pain or discomfort
69
Modified Thomas Test
Hip Muscle Imbalance / ITBFS (not specific) Procedure: - Pt half on bed, hold onto one leg & let the other fall - Looking for tightness in REC FEM, iliopsoas/ sartorius, or TFL Sartorius = ABD & ER TFL = ADD & IR REC FEM (2 joint mm) - if flex knee & it INC hip flexion - likely this mm d/t passive insufficieny
70
Ely's Test
Hip Muscle Imbalance Procedure: - Pt is prone, flex knee & hip goes into flexion = again b/c of passive insufficiency
71
Ober's Test
Hip Muscle Imbalance / ITBFS (Not specific) Tightness in ITB Procedure: - Pt is side-lying with leg abducted & release leg - want to see it drops to other leg - If it says suspened = ITB tightness
72
Piriformis Test
Hip Muscle Imbalance Pt is side-lying in 60-90 degree if flex & adducting leg down (+) = reproduction of symptoms OR cannot bend their knee all the way down
73
90/90 Straight Leg Raising Test
Hip Muscle Imbalance Pt knee & hipp in 90 degrees flexion & passively extending one knee at a time Assessing hamstring tightness
74
**Barlow manuever**
Screening for infants w/ DDH under 1 month **Barlow manuever** Procedure: The infant's hip is **adducted** while applying a **mild posterior directed force** through knee (+) = There is a **palpable subluxation or dislocation of the hip**
75
**Ortolani manuever**
Screening for infants w/ DDH under 1 month **Ortolani manuever** Procedure: The infant's **hip & knees are flexed to 90 degrees** & is gently **abducted** while applying an **anterior directed force** on the proximal femur (+) = There is a **palpable & audible clunnk as the hip reduces**
76
McMurray's Test
Meniscal Tear
77
Apley's Test
Meniscal Tear
78
Thessaly Test
Meniscal Tear
79
"Bounce Home" Test
Meniscal Tear
80
Anterior Drawer Test
Anterior Cruciate Ligament Tear
81
Lachman's Test
Anterior Cruciate Ligament Tear
82
Pivot-Shift Test
Anterior Cruciate Ligament Tear
83
Posterior Drawer Test
Posterior Cruciate Ligament Tear
84
Posterior Sag Sign
Posterior Cruciate Ligament Tear
85
Godfrey (Gravity) Test
Posterior Cruciate Ligament Tear
86
Clarke's Sign (Patellar Grind Test)
Patellofemoral Pain Syndrome
87
McConnel Test
Patellofemoral Pain Syndrome
88
Step-Up Test
Patellofemoral Pain Syndrome
89
Eccentric Step Test (Step-Down Test)
Patellofemoral Pain Syndrome
90
Hoffa's Test
Infrapatella Fat Pad Impingement Syndrome Hoffa's Test PT palpates both sides of patella @ joint line & take from full FLEX > EXT = fat pad is translating forward ANTERIORLY & can poke out aginst finger **~20 degrees**
91
Fairbank's Apprehension Test
Patellar Subluxation/ Dislocation
92
Noble Compression Test
ITBFS
93
Anterior Drawer Test (of the ankle)
Lateral (Inversion) Ankle Sprain
94
Talar Tilt (Inversion Stress Test)
Lateral (Inversion) Ankle Sprain
95
Talar Tile (Eversion Stress Test)
Medial (Enversion) Ankle Sprain
96
External Rotation Stress Test
Medial (Enversion) Ankle Sprain / High ankle sprain
97
Squeeze Test
High Ankle Sprain (Syndesmotic Ankle Sprain)
98
99
Thompson's Test
Achilles Rupture
100
Stress Fracture Test (tuning fork vibration)
Stress Fracture Test (tuning fork vibration) - Make fork vibrate - touch the bone & this irritates the places w/ hairline # Another test: use ULTRASOUND & crank it up - go over area w/ hairline fracture > pt will say it is painful - soundwaves are getting into the cracks in the bone & irritating it
101
Morton's Test
Morton's Neuroma
102
Allen Test
TOS Position: The test is best performed with the patient in a relaxed sitting position. The arm to be tested should be in 90 degrees of abduction and full external rotation. The elbow should be in 90 degrees of flexion. Procedure: - The patient rotates the head to the side opposite the arm being tested while the examiner palpates the radial pulse. - The examiner can also palpate the radial pulse continuously as the patient moves from having the arm in a neutral position as the patient moves the arm and head into the end position of the test. (+) = radial pulse becomes diminisged or absent after rotation of the head
103
Crank (apprehension) & relocation test
Jobe Relocation Test (also referred to as the Fowler Sign) is to test for anterior instability of the glenohumeral joint. - **often administered after the Apprehension Test** Position: - The patient is positioned supine, with the elbow flexed to 90 degrees and abducted to 90 degrees Procedure: - The therapist then applies an external rotation force to the shoulder, - **If** the patient reports apprehension in any way, the Apprehension Test is considered to be positive. - At this point, the therapist may apply a posteriorly directed force to the shoulder - **If** the patient's apprehension or pain is reduced in this position, the Jobe Relocation Test is considered to be positive
103
104
Allen Test
TOS Position: The test is best performed with the patient in a relaxed sitting position. The arm to be tested should be in 90 degrees of abduction and full external rotation. The elbow should be in 90 degrees of flexion. Procedure: - The patient rotates the head to the side opposite the arm being tested while the examiner palpates the radial pulse. - The examiner can also palpate the radial pulse continuously as the patient moves from having the arm in a neutral position as the patient moves the arm and head into the end position of the test. (+) = radial pulse becomes diminisged or absent after rotation of the head
104
105
Crank (apprehension) & relocation test
Jobe Relocation Test (also referred to as the Fowler Sign) is to test for anterior instability of the glenohumeral joint. - **often administered after the Apprehension Test** Position: - The patient is positioned supine, with the elbow flexed to 90 degrees and abducted to 90 degrees Procedure: - The therapist then applies an external rotation force to the shoulder, - **If** the patient reports apprehension in any way, the Apprehension Test is considered to be positive. - At this point, the therapist may apply a posteriorly directed force to the shoulder - **If** the patient's apprehension or pain is reduced in this position, the Jobe Relocation Test is considered to be positive
105
106
Before you can use the release or surprise test the patient has to have had apprehension during the apprehension test that was reduced during at AP glide of the relocation test. The “surprise” comes from spontaneously releasing the Anterior-posterior directed pressure on the glenohumeral joint. This should result in re-elicitation of the patient’s fear of luxation and indicates a positive test. Be careful to not bring the arm into further external rotation or horizontal abduction while releasing as you may risk anterior luxation!
107
Crank (apprehension) & relocation test
Jobe Relocation Test (also referred to as the Fowler Sign) is to test for anterior instability of the glenohumeral joint. - **often administered after the Apprehension Test** Position: - The patient is positioned supine, with the elbow flexed to 90 degrees and abducted to 90 degrees Procedure: - The therapist then applies an external rotation force to the shoulder, - **If** the patient reports apprehension in any way, the Apprehension Test is considered to be positive. - At this point, the therapist may apply a posteriorly directed force to the shoulder - **If** the patient's apprehension or pain is reduced in this position, the Jobe Relocation Test is considered to be positive
108
Crank (apprehension) & relocation test
Jobe Relocation Test (also referred to as the Fowler Sign) is to test for anterior instability of the glenohumeral joint. - **often administered after the Apprehension Test** Position: - The patient is positioned supine, with the elbow flexed to 90 degrees and abducted to 90 degrees Procedure: - The therapist then applies an external rotation force to the shoulder, - **If** the patient reports apprehension in any way, the Apprehension Test is considered to be positive. - At this point, the therapist may apply a posteriorly directed force to the shoulder - **If** the patient's apprehension or pain is reduced in this position, the Jobe Relocation Test is considered to be positive
109
Crank (apprehension) & relocation test
Jobe Relocation Test (also referred to as the Fowler Sign) is to test for anterior instability of the glenohumeral joint. - **often administered after the Apprehension Test** Position: - The patient is positioned supine, with the elbow flexed to 90 degrees and abducted to 90 degrees Procedure: - The therapist then applies an external rotation force to the shoulder, - **If** the patient reports apprehension in any way, the Apprehension Test is considered to be positive. - At this point, the therapist may apply a posteriorly directed force to the shoulder - **If** the patient's apprehension or pain is reduced in this position, the Jobe Relocation Test is considered to be positive