Special Tests Flashcards
Thompson test
Patient in prone with feet extended over edge of table. PT asked patient to relax, proceeds to squeeze muscle belly of gastrocnemius/ soleus.
Positive = absence of plantar flex, indicates ruptured Achilles tendon
Apley’s compression test
Patient in prone with knee at 90° flex. PT stabilizes femur using one hand, places other hand on patients heel. PT medially/laterally rotates tibia while applying compressive force through tibia.
Positive= pain/clicking, indicates meniscal lesion
Hawkins- Kennedy Impingement
pt sitting/standing. PT flexes shoulder to 90˚ and medially rotates arm Positive = pain, May indicate shoulder impingement involving supraspinatus tendon
Posterior drawer test
Patient in supine with me at 90° flex and hip 45° flex. Therapist stabilizes lower leg by sitting on forefoot. Therapist grasps proximal tibia with both hands, places thumbs on tibial plateau, administers posterior directed force to tibia on femur.
Positive= Excessive posterior translation of tibia on femur with diminished/absent and point, may indicate PCL injury
Patrick’s Test (aka Faber’s Test)
pt in supine w/ test leg flexed, ABD and lat rotated @ hip onto opposite leg. PT slowly lowers test leg through ABD toward table
Positive= failure of test led to ABD below level of opposite leg- may indicate iliopsoas/ sacroiliac/ hip joint abnormalities
Patellar tap test
Patient in supine with knee flexed or extender to point of discomfort. PT applies slight tap over patella.
Positive = patella appears to be floating, indicates joint effusion
90-90 straight leg raise test
pt in supine w/ hips @ 90˚ flex and knees relaxed. pt then alternately extends each knee as much as possible while maintaining 90 hip flex Positive= knee remains 20˚+ flex, May indicate tight hamstrings
Lateral pivot shift test
Patient in supine with hip flexed and abducted to 30° with a slight medial rotation. Therapist grasps leg with one hand, places other hand over lateral surface of proximal tibia. Therapist medially rotates tibia and applies valgus force to knee while knee is slowly flexed.
Positive= Palpable shift or clunk occurring between 20 and 40° of flexion, indicates anterolateral rotary instability
True leg length discrepancy
Patient in supine with hips and knees extended, legs 15 to 20 cm apart, pelvis in balance with legs. Using tape measure, PT measures from distal point of ASIS to disappoint of medial malleolus.
Positive = bilateral variation of greater than 1 cm, indicates true leg length discrepancy
Posterior sag sign
Patient in supine with knee at 90° flex and hip at 45° flex.
Positive= tibia sagging back on femur, may indicate PCL injury
Cozen’s test
pt sitting w/ elbow in slight flex. PT places thumb on later epicondyle while stabilizing elbow joint. pt makes fist, pronates forearm, radially deviates, and extends wrist against resistance Positive= pain in lateral epicondyle region/ muscle weakness, May indicate lateral epicondylitis
Neer Impingement
pt sitting/standing. PT places one hand on posterior aspect of scapula, stabilizes shoulder with other hand, then elevates arm through flex Positive= grimace/pain, May indicate shoulder impingement involving supraspinatus tendon
Talar tilt
Patient inside lying with knee flexed to 90°. PT stabilizes distal tibia with one hand, grasps talus with other hand. Foot maintained in neutral position. PT tilts Talus into ABD/ADD.
Positive = excessive abduction, indicates calcaneofibular ligament sprain
Yergason’s test
pt in sitting w/ 90˚ elbow flex and forearm pronated. Pt places one hand on pt’s forearm, the other over bicipital groove and resists active supination and lateral rotatation Positive = pain/tenderness in bicipital groove, May indicate bicipital tendinitis
Adson Maneuver
pt sitting/standing. PT monitors radial pulse as pt rotates head TOWARD test shoulder. pt then extends head while PT lat. rotates and extends shoulder Positive= absent/diminished radial pulse, May indicate thoracic outlet syndrome
Medial epicondylitis test
Patient in sitting. PT palpates medial epicondyles, supinates patients forearm, extends wrist, extends elbow.
Positive= pain in medial epicondyle region, may indicate medial epicondylitis
Trendelenburg Test
pt in standing, stands on one leg for approx 10 sec
Positive= drop of pelvis on unsupported side, may indicate weak glute medius on supported side
Tinel’s Sign
pt in sitting w/ elbow in slight flex, PT taps between olecranon process and medial epicondyle using index finger Positive= tingling sensation in ulnar nerve distribution of forearm, hand and fingers, indicate carpal tunnel syndrome due to median nerve compression
Ober’s test
pt in sidelying w/ lower leg flexed @ hip & knee. PT moves leg into hip ext & ABD, then attempts to slowly lower test leg Positive= inability to adduct test leg to table, indicate TFL contracture https://www.youtube.com/watch?v=bDAHkXO1YWk
Roos Test
pt sitting/standing w/ arms @ 90˚ ABD, Lat rotation, elbow flex. pt asked to open/close hands for 3 min. Positive= inability to maintain test position/ weakness of arms/ sensory loss/ ischemic pain, May indicate thoracic outlet syndrome
Lachman Test
pt in supine w/ knee flexed to 20-30 degrees therapist stabilizes distal femur with one hand, places other hand on proximal tibia. PT applies anterior forces to tibia on femur.
Positive= excessive anterior translation of tibia on femur with diminished/absent endpoint
May indicate ACL injury
Lateral Epicondylitis test
pt in sitting, PT stabilizes elbow, places other hand on dorsal aspect of hand distal to proximal interphanageal joint. pt must resist ext of 3rd digit Positive= pain in lat. epicondyle region/ muscle weakness, May indicate lateral epicondylitis
Froment’s Sign
pt in sitting/standing holds piece of paper between thumb and index finger. PT attempts to pull paper away from pt. Positive= pt flexes distal phalanx of thumb due to add. policis paralysis/ pt hyperextends metacarophalangeal joint of thumb (Jeanne’s sign)
May indicate ulnar nerve compromise or paralysis
Allen Test
pt sitting/standing w/ test arm @ 90˚ ABD, lat rotation, elbow flex. pt then rotates head AWAY from test shoulder while PT monitors radial pulse Positive= absent/diminished radial pulse, May indicate thoracic outlet syndrome
Brush test
Patient in supine. PT places one hand below joint line on medial surface of patella and strokes proximately with palm and fingers towards suprapatellar pouch.
Positive= wave of fluid just below medial distal border of patella, indicates knee effusion
Phalen’s test
pt in sitting/standing, wrists flexed maximally and held for 60 sec. Positive= tingling in thumb, index, middle and lat. half of ring finger (carpal tunnel) https://www.youtube.com/watch?v=RpGHYujo37o
Varus stress test
Patient in supine with knee flexed 20 to 30°. PT positions one hand on lateral surface of ankle, other hand on medial surface of knee. PTA applies Varus force to knee with distal hand.
Positive= excessive Varus movement, may indicate LCL sprain
Supraspinatus test
Patient positioned with arm in 90° abduction followed by 30° horizontal ad duction with some pointing down. PT resists patients attempt to abduct arm.
Positive= weakness/pain, may indicate supraspinatus tendon tear, Impingement, suprascapular nerve involvement
Finklestein’s Test
pt in sitting/standing makes a fist w/thumb tucked inside fingers. PT stabilizes forearm and ulnarly deviates wrist Positive= pain over ABD pollicis longus and ext pollicis brevis @ wrist, May indicate de Quervain’s tenosynovitis in thumb
Ely’s test
pt positioned in prone while PT passively flexes knee Positive= spontaneous hip flexion occuring simultaneously w/ knee flex, May indicate rectus femoris contracture
Speed’s Test
pt in sitting/standing w/ elbow extended & forearm supinated. PT places one hand on bicipital groove, other on volar surface of forearm and resists active shoulder flex. Positive = pain/tenderness in bicipital groove, may indicate bicipital tendinitis
Drop Arm test
pt sitting/standing w/arm @ 90˚ shoulder ABD. pt slowly lowers arm to side Positive = pt “drops” affected arm/ experiences severe pain, May indicate rotator cuff tear
McMurray test
Put in supine. PT grasps distal leg w/ one hand, palates knee joint with other. With knee fully flexed, PT medially rotates tibia and extends knee. Put repeats while lat rotating tibia
positive= click/ pronounced crepitation felt over joint line, indicates posterior meniscal lesion
Piriformis test
pt in sidelying w/ test leg toward ceiling and hip flex @ 60˚. PT places one hand on pt’s pelvis and other on pt’s knee. PT applies downward force on knee while stabilizing pelvis Positive= pain/ tightness, indicates piriformis tightness/compression on sciatic nerve
Valgus stress test
Patient in supine with me at 20 to 30° flex. PT positions one hand on medial surface of ankle, other hand on lateral surface of knee. PT applies Valgus force to knee with distal hand.
Positive= Excessive valgus movement, may indicate MCL sprain
** positive test with knee in full extension may indicate damage to MCL, PCL, posterior oblique ligament, and posteromedial capsule
Shoulder Apprehension dislocation Test
Anterior: pt in supine w/ arm @ 90˚ ABD. PT laterally rotates shoulder- positive = pt grimace before reaching endpoint Posterior: pt in supine w/ arm @ 90˚ flex and medial rotation. PT applies posterior force though long axis of humerus- positive = pt grimace before reaching endpoint
Craig’s test
pt in prone w/ test knee in 90˚ flex. PT palpates poterior greater trochanter and med/lat rotates hip till GT is parallel w/ table. The degree of femoral anteversion corresponds to angle formed by lower leg w/ perpendicular surface of table, normal anteversion for adult is 8 to 15°
Tripod test
pt in seated w/ knees @ 90˚, PT passively extends one leg Positive= hamstring tightness/ trunk extension
Anterior Drawer Test
pt in supine w/ knee flexed to 90˚ and hip flexed to 45˚. PT stabilizes lower leg by sitting on forefoot, grasps pt’s tibia w/ two hands, places thumbs on tibial plateau and administers anterior force to tibia on femur
Positive= ecessive anterior tibial translation onto femur w/diminished/absent endpoint, may indicate ACL injury
Thomas test
pt in supine w/ legs fulled ext. pt brings one knee to chest to flatted lumbar spine while PT observes contralat hip Positive= straight leg rises from table, indicates hip flexion contracture
