Spine Functional/Special Tests Flashcards
Straight Leg Raise
-test for sciatic n
- Test both sides
- passively raise leg
- DF
- Pt lift head
Pain in 0-30: acute/severe MSK
Pain in 30-70: nerve issue
Pain >70: not positive
Crossed SLR sign: opposite s/s, disc protrusion
Sensitizers:
-Tibial: DF > Eversion > Toe Ext
-Sural: DF > Inversion
-Common fib: PF > Inversion
Slump Test
-test neuromobility
- Hands behind back
- Head and neck flexed
- Lumbar flx
- Straighten knee
- overpressure
- DF of ankle
- Pt moves head
SIngle Limb Stance (SLS)
Note:
-abnormal postural sway
-assistance
-Sx
-side ot side diff
-(+) Trendelenberg Sign
-Poor balance (<30s)
Single Limb Squat
Note:
-depth
-assistance
-Sx
-side ot side diff
-(+) Trendelenberg Sign
-Poor balance (<30s)
Functional Tasks
-Lifting
-Squatting
-Bending
-Twisting
-assess quality and duration of movement prior to pain
Repeated Movements Testing
-Radiating S/s ONLY
Extension: 80%
-prone to standing
-10 reps
-want centralization
Flexion:
-Supine to standing
-10 reps
-want centralization
Sorenson Test
-muscle endurance and strength test
-stopped at 4 mins if continue
5: hands across chest 20-30s)
4: Hands at side (15-20)
3: Hands at siide (10-15)
2: Hands at side (1-10)
Dynamic Abdominal Endurance Test
-muscle endurance and strength test
5: hands behind neck (20-30s)
4: Hands crossed on chest (15s)
3: Arms straight (10-15)
2: Hands straight toward knees (1-10)
1: Unable to raise more than head
Flexibility Tests
-Psoas
-Rec Fem
-Piriformis (>90 IR)
-Hamstring
Prone Knee Bend
-Neuroprovocation Test
-tests femoral nerve
- Pt prone
- PT papssively flexes knee
- (+)= S/s 80-100 degs
- (-)
- Absense of s/s
-<80 deg knee joint dysfunction
->100 deg RF or spine dysfunction
Spinal Joint Play
-hypo, hyper, normal
Central (CPA):
-palpate SPs
-pisiform and push
-INCLUDE SACRUM
Unilateral (UPA):
-palpate opposite TP
-Thumbs and push
Prone Instability Test
-when you suspect instability
-hypermobile joint play
- Pt in prone with legs off
- Relaxed, PT push on symptomatic joint segments
- if painful, have Pt lift legs and push again
-(+): pain gets better - Repeat on each hypermobile section from joint play
Stoop Test
-for intermittent claudication****
-bike or walking
- Start upright and time until Sx occur
- Stoop until Sx occur
(+): Sx improve w Stopped posture (takes longer to produce)
Waddell’s Test
-for non-organic Sx
-need 3 or +/5
- Stimulation
-gently compress head, Pt response
-trunk rotation at hips, Pt response - Regional
-sensory weakness or weakness in whole area and not pattern - Tenderness
-superficial brush on skin in non-surgical area - Distraction
-look for inconsistencies
-SLR: distraction no response, response when brought to their attention
-Bending
-Limping - Over-Reaction
-less reliable
Contraindications for Manual Therapy
-infection*
-Fever*
-Cancer*
-Acute Circulatory Condition
-Open Wound
-Fracture*
-Hematoma
-Advanced DM
-Hypersensitivity
-Hypermobility*
-Abnormal Endfeel*
-RA
-Cellulitis
-Constant, Severe pain
-Extensive radiation of pain*
-Condition not evaluated
Precautions for Manual Therapy
-Joint effusion or inflammation*
-RA (non-exacerbation)
-Osteoporosis*
-Pregnancy (over spine)*
-Dizziness*
-Steroid or anti-coagulant
Examination to Treatment w/ Mobilizations
- Baseline Assessment
-pain, s/s, ROM, Strength - Determine Grade
-impairment, stage, irritability - Contraindications and Precautions
- Take up Slack
-assess joint play - Arthrokinemattics and Pt Position
- Only 1 Surface Moves
- Re-assess after Treatment
-pain, s/s, ROM, Strength
Sidelying Lumbar Gapping
- Pt Sidelying
- Palpate L5-L4
- Flex sup leg until movement at L5
- Rotate Arm/trunk until Movement at L3
- Rotate in opposite directions
add HVLAT for manipulation
Million Dollar Roll
1.Pt Supine
2.Banana shape with Pt on outside of curve
3.Roll trunk toward PT
4.Place resistance on opp ASIS
5. Rote in opposite directions
add HVLAT for manipulation
Lumbar Gapping MET
- Pt Sidelying
- Palpate L5-L4
- Flex sup leg until movement at L5
- Rotate Arm/trunk until Movement at L3
- Rotate in opposite directions
- Have Pt try to unwind against PT
-hold for 6 sec, relax, go further
Opening Restriction MET
Opening on down side
- Pt Sidelying
- Palpate L5-L4
- Flex BOTH legs until movement at L5
- Rotate Arm/trunk DOWN until Movement at L3 (flexion bias)
- Lift BOTH legs
- Ask Pt to gently push into hands
-hold for 6s, relax, go further
Closing Restriction MET
Closing on up side
- Pt Sidelying
- Palpate L5-L4
- Flex SUP leg until movement at L5
- Rotate Arm/trunk UP until Movement at L3 (extension bias)
- Lift SUP leg
- Ask Pt to gently push into hands
-hold for 6s, relax, go further
-might not be great IR
Adduction Isometric for Anterior pelvic/SIJ Pain MET
-Pt in hooklying
-PT pushes against medial knees to resist add the switch to resisit abduction (can use chest)
-Pt pushes against for 3 seconds 3x
