Special Test Flashcards

1
Q

Slump Test

A

Purpose:
adverse nerve root tension (sciatic nerve and cervical and lumbar nerve roots)

Steps:
Patient Position:
Sit, arm behind back
Order:
Slump–>passive neck Flex–>Passive knee Ext–>passive DF
*Stop when S/S produced
Repeat with the other leg

+ve:
Reproduce Pt’s S/S or sciatic pain

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2
Q

Straight Leg Raise

A

Purpose:
adverse nerve root tension (sciatic nerve and nerve roots L4-S2)

Steps:
Patient Position:
Supine
PT:
Passive hip Flex+ Knee Ext
- Stop when S/S produced
- Lower the leg–> add sensitizer (e.g. passive DF/active neck flex)

+ve:
- between 35-70 deg: reproduction of symptoms
- >70 deg: SIJ, Hamstring

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3
Q

Prone Knee Bend

A

Purpose:
adverse nerve root tension (femoral nerve and nerve roots L2-L4)

Steps:
Patient Position:
Prone
PT:
Passive Knee flexion+stabilize hip (prevent Rot)

+ve:
- Unilateral lumbar, buttocks or posterior thigh pain
- Anterior thigh pain = quadriceps tightness or stretching of the femoral nerve

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4
Q

Bicycle Test

A

Purpose:
neurogenic intermittent claudication (IC) – indicative of spinal stenosis

Steps:
Patient Position:
1. On bike+lean backward–>
pain in the buttock & post. thigh+tingling
2. Lean forward
+ve: pain subside after short amount of time
3. lean back again

+ve:
pain return at step 3=neurogenic IC
no change in pain with leaning forward/backward= vascular IC

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5
Q

Thigh thrust

A

Purpose:
SIJ pain

Steps:
Patient Position:
Supine with affected side in 90 hip Flex

PT:
- stabilize pelvis with hand over opposite ASIS
- stand at the tested side–>pressure through the thigh along the femur

+ve:
Reproduction of patient’s pain in their SI joint

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6
Q

Sacral Thrust

A

Purpose:
SIJ pain

Steps:
Patient Position:
Prone

PT:
- both hands on the sacrum
- Ant. pressure down the sacrum–>ant. shearing force at both SIJ

+ve:
Reproduction of patient’s pain in their SI joint

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7
Q

Gaenslen’s

A

Purpose:
- SIJ pain
- Hip pathology/L4 nerve root lesion

Version 1:
Patient Position:
1. Supine with test hip Ext beyond the edge of the table
2. Draw both legs up to chest and slowly lower tested leg into Ext

PT:
- Stabilise the flexed non-tested leg by placing hand over patient’s hand

Version 2:
Patient Position:
1. Side lying on the non-tested side+ hyperextended the tested leg
2. Hold the lower non-test leg flexed to the chest

PT:
- Stabilizes the pelvis while extending the hip of the upper test leg

+ve:
Reproduction of patient’s pain in their SI joint

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8
Q

Distraction

A

Purpose:
SIJ pain

Steps:
Patient Position:
supine+forearm under Lx for maintaining lordosis+support the spine

PT:
- hands on bil. ASIS with arm crossed and below string
- Slow posterior force by learning down toward the patient

+ve:
Reproduction of patient’s pain in their SI joint

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9
Q

Compression

A

Purpose:
SIJ pain

Steps:
Patient Position:
Sidelying on non-tested side, pillow between the knees

PT:
- hands on ant. aspect of lateral ilium, between GT & iliac crest
- steady downward pressure

+ve:
Reproduction of patient’s pain in their SI joint

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10
Q

Kinetic Test (aka Stork Test or Gillet’s Test)

A

Purpose:
Assess movement, asymmetry/ dysfunction of the SI joint

Steps:
Patient Position:
1. Standing
2. Then raise the tested side leg up 90 deg hip Flex (SLS)

PT:
- Find PSIS first and go medially to find S2
- one thumb on tested side PSIS, one thumb on S2

*Perform the test on both sides

+ve:
If the SI joint on the side on which the knee is flexed moves minimally or up, the joint is said to be hypermobile or “blocked”

Normal: PSIS move down

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11
Q

FABER (aka Jansen’s Test)

A

Purpose:
Detects limitation of motion in the hip or possible SI joint dysfunction

Steps:
Patient Position:
supine, make a figure of 4 with the tested side

PT:
- hands on opposite ASIS+tested side knee
- Gentle downward force to exaggerate the Abd&ER

+ve:
1. Reproduction of pain/
2. tested leg’s knee remains above the opposite straight leg.

-ve:
- tested leg’s knee falls to the table or is at least parallel with the opposite leg

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12
Q

Thomas Test

A

Purpose:
hip flexion tightness or contracture

Steps:
Patient Position:
- Supine
- later hold the flexed hip

PT:
- check for excessive lordosis first
- flex non-tested side hip to chest
- check the straight leg

+ve:
the straight leg rises off the table

-ve:
the straight leg remains on the table

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13
Q

Modified Thomas Test

A

Purpose:
hip flexion/rectus femoris tightness or contracture.

Steps:
Patient Position:
- Supine at the edge of the bed

PT:
- check for excessive lordosis first
- flex non-tested side hip to chest
- check the unsupported leg

+ve:
Hip flexor: unsupported leg remains in flexion
Rectus femoris: The tested side’s knee will be pulled straighten

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14
Q

Sign of the Buttock

A

Purpose:
RONFISS:
o Rheumatic bursitis
o Osteomyelitis of the upper femur
o Neoplasm of the upper femur
o Neoplasm of the ilium
o Fractured sacrum
o Ischiorectal abscess
o Septic sacroiliitis
o Septic gluteal bursitis

Steps:
Patient Position:
- Supine

PT:
- SLR–>limitation
- Flex the knee to try the hip flexion

+ve:
No further hip flexion occurs with knee flexion.

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15
Q

Scour Test

A

Purpose:
Indication of nonspecific hip pathology

Steps:
Patient Position:
- Supine

PT:
- flexes and adducts the tested hip (faces the patient’s opposite shoulder) and resistance is felt
- take through an arc of motion into abduction (while maintaining flexion)

+ve:
- Presence of any irregularity in movement, pain or patient apprehension during the movement.

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16
Q

Noble Compression Test

A

Purpose:
* Indication of ITB syndrome (pain, abnormalities, and tightness in ITB).
* Differential diagnosis for lateral knee pain

Steps:
Patient Position:
- Supine, knee in 90 deg Flex

PT:
- apply pressure to lateral femoral epicondyle
- slowly extend the leg

+ve:
- Pain reproduction at ~30 degrees of knee flexion.

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17
Q

True Leg Length vs. Apparent Leg Length Testing

A

True Leg Length
ASIS–>Medial (or lateral) Malleolus

Apparent Leg Length
umbilicus–>Medial (or lateral) Malleolus

+ve:
Difference side to side greater than 1.5cm

18
Q

Thessaly Test

A

Purpose:
Screening for meniscal tear

Steps:
Patient Position:
- SLS, holding on PT hands for support
- Knee flexed to 5 & 20 deg
- Twist the body both ways x 3
unaffected side first

+ve:
- Pain or audible click
When IR= lat. meniscus
When ER= med. meniscus

19
Q

Valgus and Varus Stress Test

A

Purpose:
Assesses for injuries of MCL (valgus stress) and LCL (varus stress)

Steps:
Patient Position:
- Supine

PT:
- apply valgus or valgus stress at the knee in 0 & 20 deg knee flex

+ve:
- Pain and/or excessive motion

20
Q

Swipe Test

A

Purpose:
presence of joint effusion

Steps:
Patient Position:
- Supine+ full knee extension & relax

PT:
- swipes upwards 2-3x along medial aspect of knee
- downwards on lateral side.

+ve:
Small wave or bulge on the medial aspect of knee with downward swipe

21
Q

Posterior Drawer Test for ankle

A

Purpose:
injuries of the PTFL

Steps:
Patient Position:
- Supine+ foot relaxed

PT:
- stabilizes the tibia and fibula
- holds the patient’s foot in 20 degrees PF
- pushes the talus backwards

+ve:
- Pain and/or excessive translation

22
Q

Squeeze Test

A

Purpose:
- syndesmosis injury (high ankle sprain)

Steps:
Patient Position:
- Supine

PT:
- grasps the lower leg at midcalf
- squeezes the tibia and fibula together.
- applies the same load at more distal locations moving towards the ankle

+ve:
Pain in the lower leg (provided that fracture, contusion, and compartment syndrome have been ruled out)

23
Q

External Rotation Test

A

Purpose:
- syndesmosis injury (high ankle sprain)

Steps:
Patient Position:
- seated with leg hanging over examination table with knee at 90 degrees

PT:
- stabilizes lower leg with one hand - - holds the foot at 90 degrees with the other hand
- applies a passive lateral rotation stress to the foot and ankle

+ve:
Pain over anterior or posterior tibiofibular ligaments and interosseous membrane

24
Q

Alar Ligament Rotation Test

A

Purpose:
* Assesses cervical spine stability.
* Tests the integrity of the alar ligament.

Steps:
Patient Position:
- Sitting

PT:
- stabilizes C2 by gripping the lamina and spinous process of C2 between finger and thumb
- passively rotates the patient’s head left or right moving to the “no symptoms” side first

+ve:
More than 20-30 degrees of movement possible without C2 moving =injury to contralateral alar ligament.

25
Q

Sharp-Purser

A

Purpose:
* Assesses cervical spine stability.
* Tests the integrity of the transverse ligament

Steps:
Patient Position:
- Sitting

PT:
- places one hand over the patient’s forehead.
- stabilizes the axis by placing the thumb of the other hand over the spinous process
- Patient: slowly flex their head
- applies a posteriorly directed force at the forehead

  • Normally, no motion occurs with the posteriorly directed force –> a firm capsular end feel

+ve:
The head slide backwards with the posteriorly directed force, a “clunk” may or may not occur
–>indicates that the subluxation of the atlas reduced

26
Q

Alar ligament Lateral Flexion Test

A

Purpose:
* Assesses cervical spine stability.
* Tests the integrity of the alar ligament.

Steps:
Patient Position:
- Supine with head in neutral

PT:
- stabilizes the axis with a wide pinch grip around the spinous process and lamina
- side flex the head

Normal: minimal side flexion occurs with a firm capsular end feel

+ve:
Excessive side flexion

27
Q

Spurling’s Compression

A

Purpose:
* nerve root impingement.

Steps:
Patient Position:
- Sitting

PT:
Stage 1: compresses head in neutral
Stage 2: examiner compresses head in extension
Stage 3: compresses head in extension and rotation towards unaffected side and then towards side of complaint

  • If symptoms occur at one stage, do not proceed to the next stage

+ve:
Pain radiating into the arm towards which the head is side flexed during compression.

28
Q

Dix-Hallpike Test

A

Purpose:
* benign paroxysmal positional vertigo (BPPV)

Steps:
Patient Position:
- Long sitting on the plinth

PT:
- passively rotates the head 45 deg towards the test ear
- passively extends the neck 30 deg
- lowered from sit to supine when maintaining the head position
- position maintained for 30 sec

+ve:
Presence of transient nystagmus:
- Vertical beating with torsion (post/ant canals)
- Horizontal (horizontal canal)

29
Q

AC Shear Test

A

Purpose:
AC joint injury

Steps:
Patient Position:
- sitting

PT:
- cups their hands over the deltoid
- the heel of one hand over the clavicle
- the heel of the other hand over the spine of the scapula
- squeezes their hands together

+ve:
Abnormal movement and/or pain at the AC joint.

30
Q

Allen

A

Purpose:
thoracic outlet syndrome.

Steps:
Patient Position:
- sitting

PT:
- palpate radial pulse
- Abd shoulder to 90 deg+ER+Elbow flex to 90 deg
- patient looks away

+ve:
Reproduction of symptoms and diminished or no radial pulse

31
Q

Adson

A

Purpose:
thoracic outlet syndrome.

Steps:
Patient Position:
- sitting

PT:
- palpate radial pulse
- Ext+ER+ slight abduction of shoulder
- patient Ext & Rot the neck to tested side
- patient hold breath

+ve:
Reproduction of symptoms and diminished or no radial pulse

32
Q

Roos

A

Purpose:
thoracic outlet syndrome.

Steps:
Patient Position:
- sitting
- Abd shoulder to 90 deg+ER+Elbow flex to 90 deg
- Slowly opens & closes hands x 3 minutes

+ve:
Reproduction of symptoms, tingling and numbness.

33
Q

Military Brace

A

Purpose:
thoracic outlet syndrome.

Steps:
Patient Position:
- sitting

PT:
- palpate radial pulse
- draws the patient’s shoulder down and back

+ve:
decrease pulse and or reproduction of patient reported symptoms

34
Q

Neer’s

A

Purpose:
Impingement and integrity of subacromial structures (e.g. supraspinatus tendon, subacromial bursa)

Steps:
Patient Position:
- sitting
- Shoulder in full IR + elbow Ext

PT:
- fully elevates the arm in the scapular plane

+ve:
Pain reproduction and/or apprehensive/painful facial expression

** If +ve with the arm externally rotated–> check the AC joint.

35
Q

Hawkins Kennedy

A

Purpose:
Impingement and integrity of subacromial structures (e.g. supraspinatus tendon, subacromial bursa)

Steps:
Patient Position:
- sitting
- Shoulder in 90 deg Flex, Elbow 90 deg Flex

PT:
- bring the arm into IR

+ve:
Pain reproduction and/or apprehensive/painful facial expression

36
Q

Drop Arm (Codman’s test)

A

Purpose:
Integrity of rotator cuff tendons

Steps:
Patient Position:
- Standing

PT:
- Put shoulder in 90 deg Abd
- Ask the patient to slowly lower the arm back downwards.

+ve:
- unable to lower the arm slowly
- severe pain when attempting the movement.

37
Q

Painful Arc Test

A

Purpose:
Impingement and integrity of subacromial structures (e.g. supraspinatus tendon, subacromial bursa)

Steps:
Patient Position:
- standing
- abducts arm in scapular plane
- slowly lowers arm back down

+ve:
Pain experienced between 60 and 120 degrees of abduction

38
Q

O’Brien’s

A

Purpose:
Potential labral tear (SLAP lesion).

Steps:
Patient Position:
- standing
- Shoulder 90 deg Flex+ER+elbow Ext

PT:
- bring the arm 10-15 deg of horizontal Add+full IR
- push the arm downward with the patient resisting
- repeat with the starting position

+ve:
Pain

39
Q

Maudsley’s Test

A

Purpose:
Integrity of extensor carpi radialis brevis tendon

Steps:
Patient Position:
- sitting
- elbow Ext+pronated

PT:
- resist 3rd digit extension

+ve:
- Pain reproduction at common extensor origin near the lateral epicondyle of the humerus

40
Q

Valgus and Varus Stress Test

A

Purpose:
Assesses for injuries of MCL (valgus stress) and LCL (varus stress)

Steps:
Patient Position:
- sitting/standing
- elbow flex in 20-30 deg+supination

PT:
- stabilizes the humerus with one hand and holds above the wrist with the other hand
- applies valgus or valgus stress through the elbow

+ve

41
Q

Jobe Relocation Test

A

Purpose:
Anterior shoulder dislocation (instability)

Steps:
After apprehension(crank) test, +Ve findings

PT:
- applying a posterior-directed force to the anterior aspect of the shoulder

+ve:
Pain and/or excessive motion compared to unaffected side

42
Q

Finkelstein’s

A

Purpose:
De Quervain’s

Steps:
Patient Position:
-Sitting
- makes a fist with the thumb inside the fingers+ active UD with forearm stabilized

PT:
If no pain produced during active–>
- passively moves the wrist into UD
if still pain-free
- overpressure

+ve:
Pain over abductor pollicis longus and extensor pollicis brevis tendons at the wrist