The Lumbar and Thoracic Spine: ROM, Special and Muscle Tests

Question 1

Why do we not do any PR testing when it comes to the spine?

Answer 1

Because the trunk of the body is too heavy. So we only do AF with over pressure/ AR.

Question 2

Walking through AF testing of Flexion of the spine.

Answer 2

Cl standing and tucks chin to their chest and forward bends as far as possible. If the movement was pain free then over pressure is added.

Question 3

The Movement to forward fold is initiated but which muscles and controlled by the eccentric contraction of what muscles?

Answer 3

initiated : Psoas, abdominals

controlled: sacrospinalis muscles, multifidus

Question 4

The Lumbar spine should do_____ with forward bending and not do _____ .

Answer 4

Should: Flatten

Shouldn’t: Go Kyphotic

Question 5

If there is pain with forward bending what are the first questions you should be asking?

Answer 5

Specific? Diffused? Sharp? Dull? Shooting? Burning? Numb? Down the leg?

Question 6

If you suspect a herniated disc what should you check to see?

Answer 6

Repeat Forward bending followed by extension. Does the pain centralize? if so can you use repeated extension in treatment plan.

Question 7

Walk through AF Extension.

Answer 7

Cl standing. S/he extends backwards while the therapist stabilizes the pelvis.

Question 8

Extension of the spine is controlled by _____ muscles and Initiated by _____ muscles.

Answer 8

Controlled: Abdominals
Initiated: long back extensors

Question 9

if there is pain with extension what questions should you be asking?

Answer 9

Sharp? Dull? Specific? diffuses? Shooting down or up? burning? numb? tingling?

Question 10

Walk through AF side bending.

Answer 10

Cl standing

S/he sidebends trying to reach down the side of the their leg attempting to touch their knee.

Question 11

When sidebending what should you not see as the client travels through ROM?

Answer 11

Flexing or ext.

the movement should be a pure side bend.

Question 12

Pain on the same side as the side bend indicates what about the pain? what if the pain is on the contralateral side?

Answer 12

Pain on same side = problem in muscles initiating action

Pain on opposite side = stretching of the opposite muscles that are controlling the movement.

Question 13

Why would side bending possible make someone with a herniated disc feel better?

Answer 13

The action might help to push the nucleus pulposus back into the annular fibers. With repetition the s/s should begin to centralize.

Question 14

Walk through Active Trunk Rotation.

Answer 14

Cl seated on table with feet off the ground if possible.
Cross their arms over their chest have them then turn to one side then the other.
End range is noted when contralateral knee moves forward.

Question 15

Which of the AF testing for the spine does not require over pressure?

Answer 15

extension

Question 16

why do we have the client cross there arms when testing AF rotation?

Answer 16

so they don’t use their arms to compensate.

Question 17

When is the end ROM reached in AF rotation?

Answer 17

when the contralateral knee starts to move forward.

Question 18

Which segment of the spine has the least ability to rotate?

Answer 18

The lumbar spine

Question 19

What can you do when applying over pressure to AF rotation that will ensure that the over pressure travels through the spine and not the pelvis?

Answer 19

place your thigh against the contralateral knee then apply over pressure.

Question 20

Walk through AR rotation.

Answer 20

Cl seated
Stabilize cl knee with your thigh on the side they will be rotation toward you.
Manually resist both the shoulder that comes towards you and the shoulder that is moving away from you.
Have the cl cross their arms

Question 21

Which muscle does AR rotation test the strength of?

Answer 21

This tests the ipsilateral deep rotators, internal oblique, and the contralateral external oblique

Question 22

Walk through AR Extension.

Answer 22

Cl lying prone
thera stabilize cl legs
cl places hands behind head and tries to lift their torso off the table

Question 23

If your cl is performing AR extension what is a excellent result? good? fair? poor?

Answer 23

Excellent = cl can lift up till their xiphoid process clears the table and they can cold position for a count of five.

Good = cl can’t quite hold xiphoid process off table

fair = Cl places their arms at there sides and lifts xiphoid off table.

poor = if they can’t raise xiphoid process off table at all.

Question 24

Walk through AR side bending

Answer 24

Cl is side lying
thera stabilizes lower legs
with arms crossed have client try to raise torso off table

Question 25

when performing AR side bending what is considered excellent? fair? poor?

Answer 25

Excellent = able to lift torso off table and hold for 5 seconds
Fair = able to lift but not to hold
Poor = unable to lift shoulder

Question 26

Walk through AR flexion.

Answer 26

Cl is hook lying
thera stabilizes feet and legs
have cl do a curl ( lift shoulder blades off table and hold position for a count of five.

Question 27

When should you be careful about performing AR flexion?

Answer 27

When you suspect that the cl has a disc lesion as the test increases the pressure of the disc on surrounding structures.