Special Tests Descriptions LE Flashcards
1
Q
Ely’s Test
A
Contracture/Tightness
- Patient in prone
- Therapist passively flexes patient’s knee
- Positive test indicated by spontaneous hip flexion occurring simultaneously with knee flexion
- May indicate rectus femoris contracture
2
Q
Ober’s Test
A
Contracture/Tightness
- Patient in sidelying with lower leg flexed at hip and knee
- Therapist moves test leg into hip extension and abduction, attempts to slowly lower the test leg
- Positive test indicated by inability of test leg to adduct and touch the table
- May indicate iliotibial band or TFL contracture
3
Q
Piriformis Test
A
Contracture/Tightness
- Patient in sidelying
- Test leg positioned toward the ceiling, hip flexed to 60
- Therapist stabilizes pelvis and places other hand on patient’s knee to apply adduction force
- Positive test indicated by pain or tightness
- May indicate tight piriformis or compression on sciatic nerve caused by the piriformis
4
Q
Thomas Test
A
Contracture/Tightness
- Patient in supine, legs fully extended
- Brings one knee to chest, to flatten lumbar spine
- Therapist observes the position of the contralateral hip while patient holds position
- Positive test indicated by the straight leg rising from the table
5
Q
Tripod Sign
A
Contracture/Tightness
- Patient in sitting
- Knees flexed to 90 over edge of table
- Therapist passively extends one knee
- Positive test indicated by tightness in hamstring or extension of trunk in order to limit effect of tight hamstrings
6
Q
Craig’s Test
A
Miscellaneous
- Patient in prone
- Test knee flexed to 90
- Therapist palpates posterior greater trochanter and medially and laterally rotates hip until greater trochanter is parallel with table
- Degree of femoral anteversion corresponds to the angle formed by the lower leg with the perpendicular axis of the table
- Normal anteversion for an adult is 8-15 degrees
7
Q
90-90 Straight Leg Raise Test
A
Contracture/Tightness
- Patient in supine
- Asked to stabilize hips with hips in 90 of flexion, knees relaxed
- Patient alternately extends each knee as much as possible while maintaining the hips in 90 of flexion
- Positive test indicated by knee remaining in 20 or more of flexion
- Indicates hamstring tightness
8
Q
Patrick’s Test (FABER Test)
A
Miscellaneous
- Patient in supine
- Test leg flexed, abducted, laterally rotated at the hip onto the opposite leg
- Therapist slowly loser the test leg through abduction toward the table
- Positive test indicated by failure of the test leg to abduct below the level of the opposite leg
- May indicate iliopsoas, sacroiliac, or hip joint abnormalities
9
Q
Trendelenburg Test
A
Miscellaneous
- Patient in standing
- Stands on one leg for ~10 seconds
- Positive test indicated by drop of the pelvis on unsupported side
- May indicate weakness of gluteus medius muscle on supported side
10
Q
Anterior Drawer Test
A
Ligamentous Instability
- Patient in supine
- Knee flexed to 90, hip flexed to 45
- Therapist sits on foot
- Therapist grasps proximal tibia with 2 hands, places thumb on tibial plateau, administers anterior direction force to the tibia
- Positive test indicated by excessive anterior translation of the tibia on the femur with a diminished or absent end-point
- May indicate ACL injury
11
Q
Posterior Drawer Test
A
Ligamentous Instability
- Same as Anterior Drawer Test but force applied in posterior direction
- May indicate PCL injury
12
Q
Lachman Test
A
Ligamentous Instability
-Patient in supine
-Knee flexed 20-30.
-Therapist stabilizes distal femur, places other hand on proximal tibia
-Therapist applies anterior directed force to the tibia
-Positive test indicated by excessive anterior translation of the tibia on the femur with diminished end-point
-May indicate ACL injury
(Basically Anterior Drawer Test)
13
Q
Lateral Pivot Shift Test
A
Ligamentous Instability
- Patient supine
- Hip flexed and abducted to 30 with slight medial rotation
- Therapist grasps leg with 1 hand and places 1 hand over lateral surface of proximal tibia
- Therapist medially rotates tibia and applies valgus force to knee while knee is slowly flexed
- Positive test indicated by palpable shift or clunk occurring between 20-40 degrees of flexion
- Indicative of anterolateral rotary instability
- The shift or clunk results from the reduction of the tibia on the femur
14
Q
Posterior Sag Sign
A
Ligamentous Instability
- Patient in supine
- Knee flexed to 90 and hip flexed to 45
- Positive test indicated by tibia sagging back on the femur
- May indicate PCL injury
15
Q
Valgus Stress Test
A
Ligamentous Instability
- Putting in supine
- Knee flexed 20-30
- Therapist puts 1 hand on medial surface of patient ankle, other on lateral surface of knee
- Applies valgus force to knee with the distal hand
- Positive test indicated by 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
16
Q
Varus Stress Test
A
Ligamentous Instability
- Same as Valgus Stress Test, therapist hands switch
- May indicate LCL sprain
- Positive test with knee in full extension may indicate damage to LCL, PCL, Arcuate Complex, Posterolateral Capsule
17
Q
Apley’s Compression Test
A
Meniscal Pathology
- Patient prone
- Knee flexed to 90
- Therapist stabilizes femur and puts other hand on heel
- Medially and laterally rotates tibia while applying compression through tibia
- Positive test indicated by pain or clicking
- May indicate meniscal lesion
18
Q
McMurray Test
A
Meniscal Pathology
- Patient in supine
- Therapist grasps distal leg with one hand and palpates knee joint line with the other
- With knee fully extended, therapist medially rotates tibia and extends knee
- Repeats procedure while laterally rotates tibia
- Positive test indicated by click or pronounced crepitation felt over the joint line
- May indicate posterior meniscal lesion
19
Q
Brush Test
A
Knee Swelling
- Patient supine
- Therapist places one hand below joint line on medial surface of patella
- Strokes proximally with palm and fingers to suprapatellar pouch
- Then uses other hand to stroke down lateral surface of patella
- Positive test indicated by wave of fluid below medial distal border of patella
- Indicates effusion in the knee
20
Q
Patellar Tap Test
A
Knee Swelling
- Patient supine
- Knee flexed or extended to a point of discomfort
- Therapist applies slight tap over patella
- Positive test indicated if patella appears to be floating
- May indicate joint effusion
21
Q
Anterior Drawer Test (ankle)
A
Ligamentous Instability
- Patient in supine
- Therapist stabilizes distal tibia and fibula with one hand
- Therapist holds foot in 20 of plantar flexion and draws talus forward in the ankle mortise
- Positive test indicated by excessive anterior translation of the talus away from ankle mortise
- May indicate anterior talofibular ligament sprain
22
Q
Talar Tilt Test
A
Ligamentous Instability
- Patient in sidelying
- Knee flexed to 90
- Therapist stabilizes distal tibia and grasps talus with the other hand
- Foot maintained in neutral position
- Therapist tilts talus into abduction and adduction
- Positive test indicated by excessive adduction
- May indicate calcaneofibular ligament sprain
23
Q
Thompson Test
A
Miscellaneous Ankle
- Patient prone
- Feet extended over edge of table
- While patient relaxed, therapist squeezes muscle belly of gastroc and soleus
- Positive test indicated by absence of plantar flexion
- May indicate ruptured achilles tendon
