Special tests Flashcards
Straight leg raise (SLR)
contact patient’s ankle, lift leg a little, internally rotate hip a little, adduct leg a little. Move leg up until symptoms are reproduced. POSS: radiculopathy, dural irritation, peripheral neuropathy. NB. if knee is then flexed and reduction in symptoms - positive
Crossed SLR
Same as SLR but using asymptomatic leg
Reported as having a 90% + sensitivity for radiculopathy combined with normal SLR
Braggard’s Test
(used to further tension nerve if SLR is - ve)
Perform SLR test, then lower leg just below symptomatic range and then dorsiflex foot. Reproduction of neurological symptoms may indicate a positive SLR.
Brudzinski’s Test
Patient supine with hands behind neck. Patient actively and maximally flexes neck. Reproduction of pain and / or neurological symptoms in the LEX is a positive for this test.
Kernig’s Test
Patient supine with hands behind neck.
Patient actively flexes hip with knee fully extended until pain or neurological symptoms are elicited. Patient then flexes knee.
Reduction of symptoms during knee flexion is considered a positive test as flexing the knee reduces neural tension.
Slump Test
assistswith diagnosis of radiculopathy, dural irritation, or peripheral neuropathy by increasing neural tension.
Patient seated with posterior thighs fully supported.
Patients slumps. Patient - relaxed Tsp and LSp, then chin to chest. Practitioner introduces caudal axial compression.
Practitioner gently extends one knee, dorsiflexes foot and asks patient to bear down (Valsalva test)
Bowstring Test
assists with diagnosis of radiculopathy, dural irritation, and peripheral neuropathy.
Do SLR to symptomatic range.
Whilst maintaining hip flexion, practitioner flexes the knee until symptoms are reduced.
Examiner applies pressure within the popliteal fossa and slowly extends LEX to traction sciatic nerve. Reproduction of LEX neurological symptoms is a positive test.
Median nerve test
Patient is supine, hold hand + thumb with palm open. Use leg to support arm, and hold should to prevent elevation. Abduct arm to 90-110 degrees, then externally rotate arm. Supernate forearm, extend wrist, extend elbow. Move head sidewards away from practitioner.
LSP Quadrant test
assists with diagnosis of Lsp facet joint pathology, and internal disc disruption (eg. annular tear)
Patient seated with arms folded.
Practitioner stabilizes contralateral iliac crest, and with guiding hand on patients opposite shoulder, sidebends and extends l-sp.
Apply axial compression. Repeat for other side.
Test is repeated in a flexed and sideband position on both sides.
extension - loads facet joints. flexes - loads discs
Femoral nerve traction test
same as psoas stretch ( I think)
+ve = reproduction of anterior thigh pain and / or neurological symptoms in a femoral distribution
Pelvis tests - order (3)
- Standing Flexion
- Test Stork Test
- Seated Flexion Test
Standing Flexion Test
Patient standing.
Pads of thumbs should be on the inferior slope of the posterior superior iliac spine.
Patient bends forwards smoothly.
test is +ve is one posterior superior iliac spine moves further than the other.
Median nerve test
Patient supine, practitioner depresses shoulder and abducts arm to 110 degrees. Externally rotate arm at shoulder joint. Extend arm at hummer-ulnar joint, supinate forearm, extend wrist & fingers. Contralateral then ipsilateral cervical side bending can further tension. Contralateral c-sp lateral flexion or rotation may increase symptoms, ipsilateral may decrease.
Radial nerve test
Patient supine, practitioner passively depresses patients shoulder complex, and abducts arm to 10 degrees. Pronate forearm, internally rotate shoulder, extend arm at humero-ulnar joint. Flex wrist with ulnar deviation, flex fingers. Contralateral then ipslateral cervial side bending to further tension nerve. NB. deep held inhalation may also further increase nerve compression.
