Spine Assessment

Question 1

Special Questions (8)

Answer 1

Do you have a recent injury?
Do you have a history of bone disease?
Have you been diagnosed with rheumatoid arthritis? juvenile arthritis?
Diagnosed with problems in the spine?
Have you had pins/needles in your hands?
Do you have any paraesthesia/anaesthesia?
Weakness or numbness in U.L. (L.L.)?
History of cancer? Unexplained recent weight loss? Night pain?

Question 2

Objective Examination (3)+(4)

Answer 2

AROM
PROM
Special tests:
- Pain provocation (aggravates, ease)
- Neurodynamic
- Muscular (resisted, endurance)
- Neurological (dermatomes, myotomes, deep tendon reflexes)

Question 3

Neck Pain with Mobility Deficit - Special Tests (3)

Answer 3

Limited and painful end range active, passive ROM.
Spring test
Trigger points

Question 4

Neck Pain with Radiating Pain (cervical radiculopathy) - Special Tests (2)

Answer 4

Wainner’s Cluster (3/4)
- ULNT 1
- Painful ipsilateral cervical rotation <60°
- Distraction test
- Spurling test
Peripheral neurological examination
- Dermatomes
- Myotomes
- Deep tendon reflexes

Question 5

Neck Pain with Mobility Deficits - Special Tests (3)

Answer 5

Limited and painful end range active/passive ROM
Spring test
Trigger points

Question 6

Neck Pain Movement Coordination Impairments - Special Tests (4)

Answer 6

Craniocervical flexion test
Neck flexor muscle endurance test (Harris test)
Neck extensor muscle endurance test
Sensorimotor impairment (altered muscle activation patterns, proprioceptive deficit, postural balance)

Question 7

Spring Test - Impairment, Sensitivity/Specificity, Structure, and Positive signs

Answer 7

Mobility Deficit
Sensitive test (rule out, no false negatives)
Spinous processes and facet joints.
Reproduction of pain, assessing segmental movement and pain response.

Question 8

Cervical Flexion Rotation Test - Impairment, Sensitivity/Specificity, Structure, and Positive signs

Answer 8

Cervicogenic Headache
Sensitive .9 and Specific .88 (rule in), no false positives.
Upper cervical spine.
Firm resistance, reproduction of pain, limited ROM (17°++, 17-44°+)

Question 9

Craniocervical Flexion Test - Impairment, Structure, and Positive signs

Answer 9

Movement coordination.
Deep cervical neck flexors.
Patient unable to hold 28mmHg in pillow.

Question 10

Harris Test - Impairment, Structure, and Positive signs

Answer 10

Movement coordination.
Neck Flexor endurance test.
Without pain approximately 40s.
With pain approximately 25s.

Question 11

Cervical Extensor Endurance Test - Impairment, Structure, and Positive signs

Answer 11

Movement coordination.
Cervical extensors.
Unable to hold chin tucked, unable to hold position for 20s, more than 10° of head flexion.

Question 12

Wainner’s Cluster - Impairment, Sensitivity/Specificity

Answer 12

Cervical Radiculopathy
Positive if 3 or more positive tests:
- ULNT1
- Painful ipsilateral cervical rotation <60°
- Distraction test
- Spurling test
Specific .94. Rule in.

Question 13

Spurling Test - Impairment, Sensitivity/Specificity, Structure and Positive signs

Answer 13

Radiating pain.
Specific. Rule in.
Cervical nerve root, intervertebral foramen.
Reproduction of pain, shooting and/or paraesthesia in the arm.

Question 14

Distraction Test - Impairment, Sensitivity/Specificity, Structure, and Positive signs

Answer 14

Radiating Pain.
Specific. Rule in.
Cervical nerve root, intervertebral foramen.
Decreased pain/paraesthesia in arm.

Question 15

Fingertip to Floor Test - Impairment, Sensitivity/Specificity, Structure, and Positive signs

Answer 15

Mobility Deficit.
ICC.95.
Lumbar spine.
Measurement men: 27.7 +/-16
Measurement women: 12.3 +/-16

Question 16

Modified Schöber Test - Impairment, Sensitivity/Specificity, Structure, and Positive signs

Answer 16

Mobility Deficit.
Sensitive, rule out.
Lumbar flexion deficit.
Less than 5cm increase in length with forward flexion, decreased lumbar spine ROM.

Question 17

Kemps Test - Impairment, Sensitivity/Specificity, Structure, and Positive signs

Answer 17

Radiating Pain.
Sensitive (0.7) Rule out.
Lumbar nerve root, vertebral foramen.
Reproduction of pain, shooting and/or paraesthesia in the leg.

Question 18

Prone Instability Test - Impairment, Sensitivity/Specificity, Structure, and Positive signs

Answer 18

Movement coordination.
Limited diagnostic use on its own.
Lumbar spine instability.
Pain present at resting position but decreases or resolves in the second position.

Question 19

Aberrant Movements (4) - Impairment and Positive Signs

Answer 19

Movement Coordination.
- Painful arc with flexion or return to flexion: pain during movement, not end range.
- Instability catch sign (active flexion test): Deviation from straight plane sagittal movement during flexion and extension.
- Gower’s sign: thigh climbing to return to flexion.
- Inverted lumbopelvic rhythm: bending knees when coming up from forward bent position to extend hips, shifting pelvis anteriorly.

Question 20

Supine and Prone Bridge Test - Impairment, Structure, and Positive signs

Answer 20

Movement Coordination.
Lumbar spine.
Supine: < 30 sec, Prone: <60 sec until fatigue or pain.

Question 21

Laslett’s Cluster (6) - Impairment, Structure, Sensitivity/Specificity, Positive Sign.

Answer 21

When 3/6 tests are positive, it indicates a Sacroiliac joint dysfunction. Reproduction of pain.
Sensitive .91 Specific .78.
- Thigh thrust test
- Distraction test
- Gaenslen’s test (with both legs in both positions)
- Compression test
- Sacral thrust test