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Special Test Flashcards

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1
Q

Special test for shoulder dislocation

A
  • apprehension test for anterior shoulder dislocation
  • apprehension test for posterior dislocation
  • Sulcus sign
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2
Q

Special test for biceps Tendon Pathology

A
  • Ludington’s test
  • SPeed’s test
  • Yergason’s test
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3
Q

Special test for rotator cuff Pathology/Impingement

A
  • Drop arm test
  • Hawkins-kennedy impingement test
  • infraspinatus test
  • lateral rotation lag sign
  • lift off sign (medial rotation)
  • Neer impingement test
  • Supine impingement test
  • supraspinatus test
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4
Q

Special test for thoracic Outlet Syndrome

A
  • adson maneuver
  • allen test
  • costoclavicular syndrome test
  • Roos test
  • Wright test(hyperabduction test)
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5
Q

Special test for elbow ligamentous instability

A
  • varus stress test

- valgus stress test

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6
Q

Special test for elbow epicondylitis

A
  • Cozen’s test
  • lateral epi test
  • medial epi test
  • Mill’s test
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7
Q

Special test for elbow neurological dysfunction

A
  • elbow flexion test
  • Pinch grip test
  • Tinel’s sign
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8
Q

Special test for wrist/hand ligamentous instability

A

-ulnar collateral ligament instability test

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9
Q

Special test for wrist/hand vascular insufficiency

A
  • allen test

- capillary refill test

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10
Q

Special test for wrist/ hand contracture/tightness

A
  • Bunnel-Littler test

- tight retinacular ligament test

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11
Q

Special test for wrist/ hand neurological dysfunction

A
  • carpal compression test (median nerve compression test)
  • Froment’s sign
  • Phalen’s test
  • Tinel’s sign
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12
Q

Special test for hip contracture/tightness

A
  • -Ely’s test
  • Ober’s test
  • Piriformis
  • thomas test
  • Tripod sign
  • 90-90 straight leg raise test
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13
Q

Special test for hip in pediatrics

A
  • Barlow’s test

- Ortolani’s test

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14
Q

Special test for knee ligamentous instability

A
  • anterior drawer test
  • lachman test
  • lateral pivot shift test
  • posterior drawer test
  • posterior sag sign
  • Slocum test
  • Valgus stress test
  • Varus stress test
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15
Q

Special test for knee meniscal pathology

A
  • Apley’s compression test
  • Bounce home test
  • McMurray test
  • Thessaly test
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16
Q

Special test for knee swelling

A
  • Brush test

- Patellar tap test

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17
Q

Special test for ankle ligamentous instability

A
  • anterior drawer test
  • lateral rotation stress test (Kleiger test)
  • talar tilt test
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18
Q

Special test for cervical region

A
  • cervical flexion rotation test
  • Distraction test
  • Foraminal compression test
  • Vertebral artery test
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19
Q

Special test for lumbar/sacroiliac Region

A
  • gapping test
  • Sacroiliac joint stress test
  • sitting flexion test
  • slump test
  • standing flexion test
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20
Q

apprehension test for anterior shoulder dislocation

A

test position: patient is supine with the shoulder abducted to 90 degrees and elbow flexed to 90 degrees

  • Procedure: therapist laterally rotates the shoulder
  • Positive test: a look of apprehension from the patient before an end-feel is reached which may indicate anterior shoulder instability
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21
Q

Apprehension Test for posterior shoulder dislocation

A
  • test position: patient is positioned in supine with the arm in 90 degrees of flexion and medial rotation
  • Procedure: therapist applies a posterior force through the long axis of the humerus
  • positive test: a look of apprehension or a facial grimace prior to reaching and end point
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22
Q

Sulcus sign

A
  • Test position: patient is positioned in standing
  • Procedure: therapist positions the patient’s arm in 20-50 degrees of abduction and then grasps the patient’s elbow and pulls the arm inferiorly
  • positive test: depression seen between the acromion and humeral head
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23
Q

Ludington’s test

A
  • test position: patient is positioned in sitting and is asked to clasp both hands behind the head with the fingers interlocked
  • Procedure: patient is asked to alternately contract and relax the biceps muscles
  • positive test: absence of movement in the biceps tendon may be indicative of a rupture of the long head of the biceps
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24
Q

speed’s test

A

test position: Pt is sitting or standing with the elbow extended and forearm supinated

  • procedure: therapist resists active shoulder flexion while palpating the bicipital groove
  • positive test: pain or tenderness in the bicipital groove which may indicate bicipital tendonitis
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25
Yergason's test
- test position: patient is sitting with the elbow flexed to 90 degrees and forearm pronated - procedure: therapist resists active forearm supination and shoulder lateral rotation while palpating the bicipital groove - positive test: pain or tenderness in the bicipital groove which may indicate bicipital tendonitis
26
drop arm test
- Position: patient is sitting or standing with the shoulder abducted to 90 degrees - procedure: patient is asked to slowly lower their arm - positive: presence of pain or instability to slowly lower the arm which may indicate a rotator cuff tear
27
Hawkins-Kennedy impingement
- Position: patient is positioned in sitting or standing - Procedure: therapist flexes the patient's shoulder to 90 degrees and then medially rotates the arm - positive test: pain potentially indicative of shoulder impingement involving the supraspinatus tendon
28
infraspinatus test
- position: Pt stands with their elbow flexed to 90 degrees and the shoulder in 45 degrees of medial rotation procedure: Pt resists as the therapist applies a medially directed force to the forearm - positive test: pain or weakness indicate the presence of an infrapinatus strain/tear
29
Lateral Rotation Lag sign
- position: Pt is positioned in sitting or standing - Procedure: with the patient's elbow bent, the therapist passively moves their shoulder into 20 degrees of scaption and near end-range lateral rotation and asks the patient to hold that position - positive: inability of the patient to hold the position may be indicative of infraspinatus and/or supraspinatus pathology
30
Lift off sign (medial Rotation lag sign)
- position: patient is positioned in standing with their hand on their lower back - procedure: Pt is aksed to move their hand away from their back; if they are unable to do this, the therapist shoudl passively move the patient's hand away from their back and see if they can hold the position - Positive: inability to hold the position indicates the presence of a subscapularis
31
neer impingement test
- position: Pt is positioned in sitting or standing - Procedure: therapist positions one hand on the posterior aspect of the patient's scapula and the other hand stabilizing the elbow; therapist elevates the patient's arm through flexion - positive: facial grimace or pain indicative of shoulder impingement involving the supraspinatus tendon
32
Supine Impingement Test
- position: Pt is positioned in supine - Procedure: therapist passively moves the shoulder into full flexion and laterally rotates and adducts the shoulder so that the arm is near the patient's head; the therapist then medially rotates the shoulder - Positive: Pt experiences a significant increase in pain with medial rotation
33
Supraspinatus Test
- Position: Pt is standing with the shoulder abducted to 90 degrees, then horizontally adducted 30 deg, with the thumb pointing downward - procedure: therapist resists active shoulder abduction - positive: weakness or pain which may indicate a supraspinatus tear, impingement or suprascapular nerve involvement
34
Adson Maneuver
- position: Pt is sitting or standing while the therapist monitors the radial pulse - Procedure: Pt rotates their head toward the test side, then extends their neck while the therapist extends and laterally rotates the shoulder - Positive: an absent or diminished radial pulse which may indicate TOS
35
Allen test
- position: Pt is sitting or standing with the test arm in 90 degrees of abdction, ER and elbow flexion - procedure: Pt asked to rotate the head away from the test shoulder while the therapist monitors the radial pulse - positive: absent or diminished pulse when the head is rotated away from the test shoulder, often associated with TOS`
36
Costoclavicular Syndrome test
- Position: Pt is positioned in sitting - procedure: therapist monitors the patient's radial pulse and assists the patient to assume a military posture - positive: absent or diminished radial pulse, often associated with TOS caused by compression of the subclavian artery between the first rib and the clavicle
37
Roos test
- position: sitting or standing with the arms positioned in 90 degrees of abduction, ER and elbow flexion - procedure: Pt is asked to open and close their hands for three minutes - Positive: weakness, sensory loss, ischemic pain or an inability to hold the test position which may indicate TOS
38
Wright test (hyperabduction test)
- position: Pt is positioned in sitting or supine - procedure: therapist moves the patient's arm overhead in the frontal plane while monitoring the patient's radial pulse positive: absent or diminished radial pulse and may be indicative of compression in the costoclavicular space
39
Acromioclavicular Crossover test
- position:Pt is positioned in sitting - Procedure: therapist moves the patient's shoulder into 90 degrees of flexion, then fully horizontally adducts the shoulder - positive: Pt feels pain over the acromioclavicular joint, often associated with an acromioclavicular joint injury
40
active compression test (o'Brien's test)
- position:standing with the shoulder flexed to 90 degrees, horizontally adducted 10-15 degrees, and IR so the thumb points downward - procedure: Pt resists as the therapist applies a downward force on the arm; the shoulder is then ER and the same downward force is applied - positive: Pt experiences pain when the shoulder is in IR, but has decreased pain with the shoulder ER; often indicative of a superior labral tear
41
Glenoid Labrum Tear Test
- Position: Pt is positioned in supine - Procedure: therapist places one hand on the posterior aspect of the patient's humeral head while the other hand stabilizes the humerus proximal to the elbow; therapist passively abducts and laterally rotates the arm over the patient's head and proceeds to apply an anterior directed force to the humerus - positive: clunk or grinding sound may be indicative of a glenoid labrum tear
42
Jerk test
position: sitting with the shoulder elevated to 90 degrees and in IR with the elbow bent procedure: therapist provides an axial compression force through the patient's elbow while horizontally adducting the shoulder - Positive: sudden clunk or jerk as the humeral head subluxes posteriorly indicates the presence of posterior instability
43
Varus Stress Test
- position: Pt is sitting with the elbow flexed to 20-30 degrees - procedure: therapists applies a varus force on the medial side of the elbow while palpating the lateral joint line positive: apprehension, pain or increased laxity compared to the contralateral side which may indicate a lateral collateral ligament sprain
44
Valgus Stress Test
- position: sitting with teh elbow flexed to 20-30 degrees - procedure: therapist applies a valgus force on the lateral side of the elbow while palpating the medial joint line - positive: apprehension, pain or increased laxity compared to the contralateral side which may indicate a medial collateral ligament sprain
45
COzen's test
- position: Pt positioned in sitting with the elbow in slight flexion - procedure: therapist places their thumb on the patient's lateral epi while stabilizing the elbow joint; the patient is asked to make a fist, pronate the forearm, radially deviate and extend the wrist against resistance - positive: pain in the lateral epi region or muscle weakness may be indicative of lateral epi
46
Lateral Epicondylitis Test
- position: patient is sitting with the forearm pronated - procedure: therapist stabilizes the elbow with one hand and resists active extension of the third digit with the other hand just distal to the proximal interphalangeal joint - positive: weakness or pain near the lateral epi which may indicate lateral epicondylitis
47
Medial Epicondylitis Test
Patient is sitting therapist supinates the patient's forearm, extends the wrist, and extends the elbow while palpating the medial epi - pain near the medial epicondyle which may indicate medial epi
48
mill's test
position: Pt is positioned in sitting - therapist palpates the lateral epicondyle, pronates the patient's forearm, flexes the wrist, and extends the elbow - positive: pain in the lateral epicondyle region may be indicative of lateral epicondylitis
49
elbow flexion test
- patient is positioned in sitting or standing - patient fully flexes both elbows while extending their wrists and holds the position for 3-5 minutes - positive: tingling or paresthesia noted in the ulnar nerve distribution of teh forearm and hand may be indicative of cubital tunnel syndrome
50
Pinch Grip Test
- Patient is positioned in sitting - patient is asked to pinch the tips of the index finger and thumb together - positive: inability to pinch tip-to-tip and instead pressing the pads of the fingers together may be indicative of pathology of the anterior interosseous nerve
51
Tinel's sign
- position: patient is sitting with the elbow slightly flexed - procedure: therapist taps between the olecranon process and medial epicondyle with their finger - positive: tingling sensation in the ulnar nerve distribution which may indicate ulnar nerve compression or compromise
52
Ulnar collateral Ligament Instability Test
- Patient is positioned in sitting - procedure: therapist holds the patient's thumb in extension and applies a valgus force to the metacarpophalangeal joint of the thumb - positive: excessive valgus movement may be indicative of a tear of the ulnar collateral and accessory collateral ligaments
53
Allen Test
- patient is positioned in sitting or standing - Patient is asked to open and close the hand several times in succession and then maintain the hand in a closed position; the therapist compresses the radial and ulnar arteries and then asks the patient to relax the hand while the therapist releases the pressure on one of the arteries while observing the color of the hand and fingers - positive: delayed or absent flushing of the radial or ulnar half of the hand may be indicative of an occlusion in the radial or ulnar artery
54
Bunnel- Littler test
- patient is positioned in sitting with the metacarpophalangeal joint held in slight extension - procedure: therapist attempts to move the proximal interphalangeal joint into flexion - positive: if the proximal interphalangeal joint does not flex with the metacarpophalangeal joint extended, there may be a tight intrinsic muscle or capsular tightness; if the proximal interphalangeal joint fully flexes with the metacarpophalangeal joint in slight flexion, there may be intrinsic muscle tightness without capsular tightness
55
tight retinacular ligament test
patient is positioned in sitting - proximal IP joint is held in a neutral position while the therapist attempts to flex the distal IP joint - positive: if the therapist is unable to flex the distal IP joint, the retinacular ligaments or capsule may be tight; if the therapist is able to flex the distal IP joint with the proximal IP joint in flexion, the retincacular ligaments may be tight and the capsule may be normal
56
Carpal Compression test (median Nerve compression Test)
- Patient is positioned in sitting - therapist holds the patient's wrist with both hands and applies pressure over the median nerve in the carpal tunnel for 30 seconds - pain or parethesia in the median nerve distribution may be indicative of carpal tunnel syndrome
57
froment's sign
- patient is positioned in sitting or standing and is asked to hold a piece of paper between the thumb and index finger - therapist attempts to pull the paper away from the patient - positive: patient flexing the distal phalanx of the thumb due to adductor pollicis muscle paralysis
58
Phalen's Test
- Patient is sitting or standing - therapist flexes the patient's wrists maximally and asks the patient to hold the position for 60 seconds - tingling in the thumb, index finger, middle finger, and lateral half of the ring finger which may indicate carpal tunnel syndrome due to median nerve compression
59
Finkelstein test
- patient is positioned in sitting or standing and is asked to make a fist with the thumb tucked inside the fingers - therapist stabilizes the patient's forearm and ulnarly deviates the wrist - positive: pain over the abductor pollicis longus and extensor pollicis brevis tendons at the wrist may be indicative of tenosynovitis in the thumb
60
hand Grind test
- Patient is positioned in sitting or standing - therapist stabilizes the patient's hand and grasps the patient's thumb on the metacarpal; the therapist applies compression and rotation through the metacarpal - pain may be indicative of degenerative joint disease in the carpometacarpal joint
61
murphy Sign
- patient is positioned in sitting - patient is asked to make a fist - patient's third metacarpal remaining level with the secon and fourth metacarpals may be indicative of a dislocated lunate
62
Ely's test
patient is prone therapist flexes the knee - hip flexion that occurs as the knee is flexed which may indicate a rectus femoris contracture
63
Ober's test
- patient is sidelying with the hip and knee flexed - therapist moves the hip into extension and abduction, then slowly lowers it toward the table - inability of the leg to adduct and touch the table which may indicate an iliotibial band or tensor facia latae contracture
64
piriformis test
- Patients is positioned in side lying with the test leg positioned toward the ceiling and the hip flexed to 60 degrees - therapist places one hand on the patient's pelvis and the other hand on the patient's knee; while stabilizing the pelvis, the therapist applies a downward force on the knee - pain or tightness may be indicative of piriformis tightness or compression on the sciatic nerve caused by the piriformis
65
Thomas test
- Patient is supine with the legs extended - Patient brings one knee to their chest as the therapist observes the position of the contralateral hip - straight leg rising from the table which may be indicative of a hip flexion contracture
66
Tripod Sign
- Patient is positioned in sitting with the knees flexed to 90 degrees over the edge of a table - therapist passively extends one knee - tightness in teh hamstrings or extension of teh trunk in order to limit the effect of the tight hamstrings
67
90-90 SLR test
- Patient is positioned in supine and is asked to stabilize the hips in 90 degrees of lfexion with the knees relaxed - therapist instructs the patient to alternately extend each knee as much as possible while maintaining the hip in 90 degrees of flexion - knee remaining in 20 degrees or more of flexion may be indicative of hamstrings tightness
68
Barlow's test | pediatrics
- Patient is positioned in supine with the hips flexed to 90 degrees and the knees flexed - therapist tests each hip individually by stabilizing the femur and oelvis with one hand while the other hand moves the test leg into adduction while applying forward pressure posterior to the greater trochanter - clink or a clunk may be indicative of a hip dislocation being reduced
69
Ortolani's Test | Pediatric test
Patient is positioned in supine with the hips flexed to 90 degrees and the knees flexed - Therapists grasps the legs so that their thumbs are placed along teh patient's medial thighs and the fingers are placed on the lateral thighs toward the buttocks; the therapist abducts the patient's hips and gentle pressure is applied to the greater trochanters until resistance is felt at approx 30 degrees. - positive: click or a clunk may be indicative of a dislocation being reduced
70
Anterior Labral Tear Test
- Patient is positioned in supine with the hip in full flexion, ER and abduction - therapist then moves the hip into extension, IR and adduction - presence of pain and/or a click may be indicative of an anterior labral tear
71
Craig's test
- Patient is prone with the knee flexed to 90 degrees - therapist rotates the hip until the greater trochanter is parallel with the table, then the therapist measures the angle between the lower leg and the perpendicular axis of the table - an angle less than 8 degrees indicates femoral retroversion, while an angle greater than 15 degrees indicates excessive femoral anterversion
72
Patrick's test (FABER test)
- Patient is positioned in supine with the test leg flexed, abducted, and laterally rotated at the hip onto the opposite leg - therapist slowly lowers the test leg through abduction toward the table failure of the test leg to abduct below the level of the opposite leg and may be indicative of iliopsoas, sacroiliac or hip joint abnormalities
73
Hip quadrant scouring
- Patient is positioned in supine - therapist applies a compressive force through the shaft of the femur while continuing to passively move the patient's hip - frinding, catching or crepitation in the hip may be indicative of pathologies such as arthritis, avascular necrosis or an osteochondral defect
74
trendelenburg test
- patient is standing - patient is asked to stand on one leg for ten seconds - a drop of the pelvis on the contralateral side which may indicate gluteus medius weakness on the ipsilateral side
75
Knee anterior drawer test
- Patient is supine with the hip flexed to 45 degrees and the knee flexed to 90 degrees while the therapist assists on the patient's forefoot - therapist pulls anteriorly on the proximal tibia with both hands while palpating the tibial plateau with the thumbs - excessive anterior translation of the tibia with a diminished or absent end-feel which may indicate an anterior cruciate ligament injury
76
Lachman test
- Patient is supine with the knee flexed to 20-30 degrees - therapist stabilizes the distal femur and applies an anterior force to the proximal tibia - excessive anterior translation of the tibia with a diminished or absent end-feel which may indicate and anterior cruciate ligament injury
77
lateral Pivot shift Test
- Patient is supine with the hip flexed and abducted to 30 degrees and medially rotated slightly - therapist medially rotates the tibia and applies a valgus force to the knee while the knee is slowly flexed - a palpable shift or clunk between 20 and 40 degrees of flexion which may indicate anterolateral rotary instability
78
Knee Posterior Drawer test
- Patient is supine with the hip flexed to 45 degrees and he knee flexed to 90 degrees while the therapist sits on the patient's forefoot - therapist pushes posteriorly on the proximal tibia with both hands while palpating the tibial plateau with the thumbs - excessive posterior translation of the tibia with a diminished or absent end- feel which may indicate a PCL injury
79
posterior sag sign
- Patient is positioned in supine with the knee flexed to 90 degrees and the hip flexed to 45 degrees - therapist visually inspects the relative position of the tibia and the femur - tibia sagging back on the femur may be indicative of a PCL injury
80
Slocum Test
- Patient is positioned in supine with the knee flexed to 90 degrees and the hip flexed to 45 degrees - Therapist rotates the patient's foot 30 degrees medially to test anterolateral instability and stabilizes the lower leg by sitting on the forefoot; the therapist grasps the patient's proximal tibia with two hands, places their thumbs on the tibial plateau and administers an anterior directed to the tibia on the femur - movement of the tibia occurring primarily on the lateral side may be indicative of anterolateral instability
81
knee Valgus stress test
patient is supine with the knee flexed 20-30 degrees - therapist applies a valgus force to the knee while stabilizing at the ankle with the other hand - excessive valgus movement which may indicate a medial collateral ligament sprain
82
knee varus stress test
- Patient is supine with the knee flexed to 20-30 degrees - therapist applies a varus force to the knee while stabilizing at the ankle with the other hand - excessive varus movement which may indicate a lateral collateral ligament sprain
83
APley's compression test
- patient is prone with the knee flexed to 90 degrees -therapist medially and laterally rotates the tibia at the heel while applying a compressive force through the tibia pain or clicking which may indicate a meniscal lesion
84
Bounce home test
- patient is positioned in supine - therapist grasps the patient's heel and maximally flexes the knee followed by the knee being extended passively - incomplete extension or a rubbery end-feel may be indicative of a meniscal lesion
85
mcmurray test
- Patient is positioned in supine - therapist grasps the distal leg with one hand and palpates the knee joint line with the other; with the knee fully flexed, the therapist medially rotates the tibia and extends the knee and then repeats the same procedure which laterally rotating the tibia - click or pronounced crepitation felt over the joint line and may be indicative of a posterior meniscal lesion
86
Thessaly test
- Patient stands on one leg with approx 5 degrees of knee flexion while the therapist provides their hands to assist the patient with their balance - Patient rotates the femur on the tibia laterally and medially three times; the test is then repeated with a 20 degree knee bend - joint line discomfort or catching or locking in the knee may be indicative of a meniscal tear
87
knee Brush test
- patient is positioned in supine - therapist places one hand below the joint line on the medial surface of the patella and strokes proximally with the palm and fingers as far as the suprapatellar pouch; the other hand then strokes down the lateral surface of the patella - positive: wave of fluid just below the medial distal border of the patella may be indicative of effusion in the knee
88
Patellar tap test
- Patient is positioned in supine with the knee flexed or extended to a point of discomfort - therapist applies a slight tap over the patella - patella appears to be floating may be indicative of joint effusion
89
CLarke's sign
- Patient is positioned in supine with the knees extended - therapist applies slight pressure distally with the web space of their hand over the superior pole of the patella; the therapist then asks the patient to contract the quads muscle while mainatining pressure on the patella - failure to complete the contraction without pain may be indicative of patellofemoral dysfunction
90
Hughston's test
- Patient is positioned in supine - therapist flexes the knee and medially rotates the tibia with one hand while the other hand attempts to move the patella medially and palpates the medial femoral condyle - Popping sound over the medial plica while the knee is passively flexed and extended may indicate an abnormal or irritated plica
91
Noble Compression test
- Patient is positioned in supine with the hip slightly flexed and the knee in 90 degrees of flexion - therapist places the thumb of one hand over the lateral epicondyle of the femur and the other hand around the patient's ankle; the therapist maintains pressure over the lateral epicondyle while the patient is asked to slowly extend the knee - pain over the lateral femoral epicondyle at approximately 30 degrees of knee flexion may be indicative of iliotibial band friction syndrome
92
Patellar apprehension test
- Patient is positioned in supine with the knees extended - therapist places both thumbs on the medial border of the patella and applies a laterally directed force - a look of apprehension or an attempt to contract the quads, in an effort to avoid sublaxation may be indicative of patella sublaxation or dislocation
93
ankle anterior drawer test
- Patient is supine with the ankle in 20 degrees of PF - therapist stabilizes the distal tibia/ fibula while drawing the talus forward in the ankle mortise - excessive anterior translation of the talus which may indicate an anterior talofibular ligament sprain
94
Lateral Rotation Stress test (kleiger test)
- patient is seated at teh edge of a table with their knee in 90 degrees of flexion - therapist stabilizes the patient's lower leg with one hand and holds the patient's foot in neutral with their other hand; the therapist then applies a lateral rotation force to the foot - pain over teh anterior or posterior tibiofibular ligaments and the interosseous membrane may be indicative of a high ankle sprain; pain medially and the therapist identifying the talus shifting away from the medial malleolus may be indicative of a deltoid ligament tear
95
talar tilt test
- Patient is sidelying with the knee flexed to 90 degrees - therapist stabilizes the distal tibia/ fibula while tilting the talus into abduction and adduction - excessive adduction which may indicate a calcaneofibular ligament sprain
96
Homan's sign
- Patient is supine - therapist keeps the knee in extension while dorsiflexing the ankle - pain in the calf which may indicate deep vein thrombophlebitis
97
thompson test
- Patient is prone with the feet over teh edge of a table - therapist squeezes the muscle belly of teh gastrocnemius/soleus muscles - absence of plantar flexion which may indicate a ruptured Achilles tendon
98
tibial torsion test
- Patient is positioned in sitting with the knees over teh edge of a table - therapists places the thumb and index finger of one hand over the medial and lateral malleolus; the therapist then measures the acute angle formed by the axes of teh knee and ankle - normal lateral rotation of the tibia is considered to be 12-18 degrees in an adult
99
True Leg Length Discrepancy Test
- Patient is supine with the feet 15-20 centimeters apart - therapist measures with a tape measures from the distal point of the anterior superior iliac spine to the distal point of the medial malleolus - a variation of greater than one centimeter between legs which may indicate a true leg length discrepancy
100
Cervical Flexion Rotation test
- Patient is positioned in supine - therapist fully flexes the patient's cervical spine and then rotates the cervical spine in each direction while maintaining flexion - Patient should have approx 45 degrees of rotation in each direction; if the patient has limited rotation in this position, then the dysfunction is likely occuring at the AA joint
101
cervical distraction test
- Patient is positioned in sitting - therapist places one hand under the patient's chin and the other hand under the occiput; the therapist then applies an upward distraction force - pain is decreased with the distraction force and may be indicative of cervical nerve root compression
102
Foraminal Compression Test
- Patient is positioned in sitting with the head laterally flexed - therapist places both hands on top of teh subject's head and exerts a downward force - pain radiating into the arm toward the flexed side may be indicative of nerve root compression
103
Vertebral Artery Test
- Patient is positioned in supine - therapist places the patient's head into extension, ER and rotation to the ipsilateral side - dizziness, nystagmus, slurred speech or loss of consciousness may be indicative of compression of the vertebral artery
104
Lumbar Gapping
- Patient is positioned in supine - therapist crosses theri arms and applies pressure in a downward and lateral direction to each anterior superior iliac spine - if the patient experience pain in the sacroiliac, gluteus or posterior leg, the test is positive for a sprain of teh anterior sacroiliac ligaments
105
Sacoiliac joint stress test
- Patient is positioned in supine - therapist crosses their arms, placing the palms of the hands on the patient's anterior superior iliac spines; the therapist applies a downward and lateral force to the pelvis - unilateral pain in the sacroiliac joint or gluteal area may be indicative of sacroiliac joint dysfunction
106
Sitting flexion test
- patient is positioned in sitting with the knees flexed to 90 degrees and the feet on the floor with the hips slightly abducted - therapist places their thumbs on the inferior margin of the posterior superior iliac spines and monitors the movement of the bony structures as the patient bends forward and reaches toward the floor - one posterior superior iliac spine moving farther in a cranial direction may be indicative of an articular restriction
107
Slump test
- patient sits at the edge of a table and is asked to "slump" and then bring their chin toward their chest - therapist uses one hand to maintain the position of full spinal flexion while using the other hand to place the patient's ankle in full DF; the patient is then asked to actively extend the knee; if the patient cannot fully extend the knee because of pain, the therapist asks the patient to extend their neck, and then try to extend the knee again - if symptoms decrease with knee extension or the patient can extend the knee farther, the test is positive for neural tension
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