When do you perform the Spurling test?
- if patient has a suspected nerve root symptoms
- test designed to provoke symptoms
- test is positive if pain is reproduced on the original AFFECTED side
What are the four stages of the spurling test?
1) compression with head in neutral
2) compression with head in extension
3) compression with head in extension and rotation to the unaffected side
4) compression with head in extension and rotation to the affected side
What is positive if it is reverse spurling?
pain is present in the UNAFFECTED side
If reverse spurling is positive, what is it a tell tale sign for?
- a muscle spasm
- from tension myalgia and whiplash
How do you perform the Cervical distraction test?
-one hand cradling the occiput
-one hand cradling the chin
-apply a traction force
(make sure patient is in supine)
What determines a positive test for the cervical distraction test?
if symptoms reduce during testing
With what patients is sensation deficits common in?
patients with muscle weakness and impairments
What are the different ways to test for sensory testing?
- light touch
- monofilament testing
- vibratory sensation
- proprioception
How is sensory testing directed or determined?
- patient’s history
- numbness, tingling, pins, and needles
How do you perform the sensory tests?
- patient is comfortable
- vision is obscured
- explain test
- start in areas of impairment or absent sensation and progress toward normal
What does the slump test test for?
neurological test for the lower limb
What is step one of the slump test?
- patient asked to sit in a slumped position
- spine flexed and shoulders sag forward & and hold patients chin and head erect
What is step two of the slump test?
-use one arm to apply overpressure across the shoulders
What is step three of the slump test?
ask patient to actively flex cervical spine
What is step four of the slump test?
apply over pressure to spine
What is step five of the slump test?
extend knee, while holding cervical spine in flex
What is step six of the slump test?
hold knee in extension and add ankle dorsiflexion
What is step seven of the slump test?
patient will extend head, should relive symptoms
How should the patient be positioned for the slump test?
patient sits on exam table, hands behind back and feet unsupported
With the slump test, if symptoms reproduce at stage 3, do you continue on to stage 4?
no, the test is positive at stage three so you don’t need to go further
With the centralization test, if a patient has difficulty right side bending how would you perform the test?
Have patient left side bend
How many times should the patient repeat the movement for the centralization test?
5-20 times
How should the patient be positioned for the centralization test?
either standing or in prone
How do you perform the trendelenburg test/sign? What is it testing for? What determines a positive test?
- Have patient stand on one leg and non stance leg drops down
- tests for hip abductors
- positive if hip drops
