special tests/outcome measures Flashcards
cervical distraction test
used if patient experiencing radicular symptoms
one hand under chin + other around occiput, lifts upward to gently apply traction @ c-spine
positive = relief/lessened radicular symptoms
spurlings test
apply axial load by pressing straight down on head
if no symptoms, progress to extension + rotation non-affected side, then affected side.. side flexion to affected side
positive = reproduction of radicular symptoms
vertebral artery (cervical quadrant) test
patient in supine, passive extension + side flexion and holds for 10-30 seconds
if no symptoms, ipsilateral neck side flexion is added + held
positive = dizziness or nystagmus indicating CONTRALATERAL artery is being compressed
sharp-purser test
determine subluxation of C1 (atlas) - C2 (axis)
tests transverse ligament of odontoid process
hands on forehead + thumb on C2 spinous process, patient flexes neck while pressure is applied to forehead
positive = head slides backwards during movement
Hoffmanns sign
hold + stabilize proximal IP joint of middle finger while in slight flexion, flick nail with thumb - finger should flex + relax
positive = thumb flexion + adduction and index finger flexion
SLUMP test
patient sitting with legs unsupported
hands placed behind back, go into slump posture, bringing chin to chest, therapist passively extends uninvolved knee, then affected leg
if no symptoms, ankle DF added. Pt extends neck if low back/leg radiating symptoms felt
positive = relief of symptoms with neck extension, possible restriction of dura/neural roots or lumbosacral roots
SLR
patient supine, unaffected side tested, repeated with affected:
1. leg is slightly adducted + medially rotated at hip, knee kept in full extension
2. hip is flexed until pain is indicated or tightness in post. thigh
3. leg is lowered until pain/tightness disappears
4. ankle is DF or pt flexes neck
< 35’ nerve slack being taken up
@ 35’ roots under tension
60-70’ sciatic roots tense over disc
> 70’ pain likely MSK (hamstring tension)
Crossover sign
during SLR test, pain is felt in affected side when testing unaffected leg
indication of large disc bulge
Sign of the buttock
- perform SLR to point of restriction
- flex knee to see if increased hip flexion is achieved
positive = no increased hip flexion with knee flexed
INDICATES: bursitis, tumor, abscess * refer to physician
Bow-string test
after finding positive SLR at end range, knee is flexed 20’ to reduce symptoms, then pressure is applied to popliteal area using thumbs/fingers
positive = reproduction of radicular symptoms, pressure or tension in sciatic nerve
bike test
bike sitting up straight, lean forwards and continue biking
positive = can pedal further in slumped position, likely stenosis (neurogenic claudication)
quadrant test (kemps)
patient stands upright, extension + side flexion + rotation to the side of the side of pain
OP applied into extension
positive = reproduction of symptoms (back pain)
prone segmental instability test
patient prone with legs hanging off table, therapist applies PA to lumbar spine and patient lifts legs off the floor
positive = pain with legs on floor but not once lifted off
core stability + strengthening exercises indicated
McMurrays test
meniscus tear - flex knee into deep flexion, twist + extend knee
turn tibia into ER = medial meniscus
turn tibia into IR = lateral meniscus
positive = pain/clicking
Apley’s test
meniscus tear - patient in prone with knee bent 90’, compression + rotation (grind test)
positive = pain provocation
