Final Practical Prep

Question 1

Prone Instability Test

Answer 1

Patient lies prone over end of table with feet resting on floor
PT provides PA pressure to the lumbar spine at each level looking for provocation of pain
The patient is cued to lift legs off of floor
PT provides PA pressure to the lumbar spine at each level looking for provocation of pain

Positive: If pain is reduced in second movement

Question 2

Manipulation Test Item Cluster

Answer 2

Duration of symptoms <16 days
No symptoms distal to knee
Lumbar hypomobility
At least one hip with greater than 35 degrees IR
FABQ-W less than 19

4 of 5 predictors and no contraindications= manipulate

Question 3

Coordination Impairment/ Stabilization Test Item Cluster

Answer 3

Age less than 40
Positive prone instability test
Aberrant movement with ROM
SLR greater than 90 degrees

3 or the 4 findings= coordination (multifidi and transverse abdominis)

Question 4

Sacroiliac Pain Provocation Tests

Answer 4

3 positive indicates SI dysfunction

Distraction
Thigh Thrust (P4)
Gaenslen
Sacral thrust
Compression

Question 5

Distraction

Answer 5

Hands over ASIS with force directly posterior

Question 6

Thigh Thrust

Answer 6

Sacrum fixated against table and force directly posterior

Question 7

Gaenslen

Answer 7

Test right side Posterior rotation and left in anterior rotation

Question 8

Sacral Thrust

Answer 8

pt prone, Pushing anteriorly on sacrum

Question 9

Compression

Answer 9

pt sidelying, pushing on anterior iliac crest

Question 10

Gillet Test

Answer 10

Patient stands with feet 12 inches apart
Palpate S2 with one hand and iliac spine with other
Patient flexes hip and knee on side of iliac palpation

Positive: NO movement of PSIS in a posterior direction compared to S2

Question 11

Standing Flexion Test

Answer 11

Patient is standing
Palpate PSIS Bilateral
Patient forward flexes as far as possible

Positive for hypermobility if one PSIS (+) moves further cranially

Question 12

Supine to long sit

Answer 12

Patient supine
Palpate medial malleoli and note leg length
Patient long sits
Note leg length
Positive if leg length changes
Post rot short to long

Question 13

Inferior glide of hip

Answer 13

Improves flexion and abduction

Question 14

Posterior glide of hip

Answer 14

Improves flexion and internal rotation

Question 15

Anterior glide of hip

Answer 15

Improves extension and external rotation

Question 16

Scour test

Answer 16

For arthritis,

Patient is in supine close to edge of table. The examiner flexes hip to 90 degrees. Axial compression is applied as hip is moved into flexion and ADD and again in flexion and ABD

Question 17

FABER (flexion, ABD, ER)

Answer 17

Patient is supine. Hip is placed in ER and horizontal abd with crossing of foot on opposite thigh. The examiner stabilizes the pelvis and applies a downward force through knee

(-): Test leg to table or parallel with opposite leg.
(+): Test leg remaining above opposite leg (ROM limitation) or Pain.

Question 18

Arthritis Cluster

Answer 18

Squatting aggravates symptoms
Pain with active hip flexion (lateral hip /groin)
Pain with active hip extension (lateral hip/ groin)
Scour tests with ADDuction causes lateral hip pain or groin pain
Passive internal rotation ROM ≦ 25 degrees

Question 19

Trendelenburg test

Answer 19

Standing on one leg. Opposite hip drops. Gluteus medius weakness suspected

Question 20

Internal rotation-flexion-axial compression maneuver

Answer 20

Patient is supine. Examiner flexes and internally rotates hip. Then applies axial compression. Provocation of pain is positive for suspected labral tear

Question 21

Flexion-adduction-Internal rotation test/ Click test/ (FAIR?)

Answer 21

Patient is sidelying. Examiner stabilizes pelvis while moving patients hip through 50-100 degrees flexion with Adduction and IR. Presence of a click is positive for possible labral tear.

Question 22

FADDIR

Answer 22

Anterior labral tear,

Position: Supine, place test leg (start position) into full Flex, LR, & full Abd.

Test: Clinician Ext hip with MR & Add..

(+): Pain or Reproduction S/S with or without “click”.

Question 23

Posterior Labral Tear Test

Answer 23

Position: Supine, place test leg (start position) into full Flex, MR, & Add.
Test: Clinician Ext hip with LR & Abd.

(+): Pain or Reproduction S/S with or without “click”.
Groin pain or patient apprehension.

Question 24

Quadriceps AngleQ Angle

Answer 24

Patient supine. Knee in extension but not hyperextended. Proximal arm of goniometer is aligned with ASIS and distal arm with tibial tubercle. Fulcrum is at patella.
Some therapists will perform in standing to mimic function in normal weight bearing
Normative value: 13.5 +/- 4.5 degrees

Question 25

Lachman test

Answer 25

For ACL, Patient supine with knee flexed between 10-20 degrees and femur stabilized with one hand. Examiner uses other hand to anteriorly translate tibia

Question 26

Anterior Drawer

Answer 26

For ACL, Patient supine. Knee is flexed between 60-90 degrees and foot on table. Examiner draws tibia anterior. (could be some hamstring guarding)

Question 27

Pivot shift test

Answer 27

FOr ACL, Patient supine. Examiner lifts heal of foot to flex hip to 45 degrees. Knee placed in 10-20 degrees flexion. Examiner performs forceful IR of tibia and fibula while creating valgus force at knee. Positive if tibial plateau subluxes anteriorly.

Question 28

Posterior drawer

Answer 28

for PCL, apply force posterior on tibia

Question 29

Varus and valgus stress tests

Answer 29

For collateral ligaments, Patient supine with knee flexed 20 degrees. Varus and valgus force applied at joint line. Positive is pain or laxity.

Question 30

McMurray

Answer 30

For meniscus, Patient supine. Examiner brings knee from extension to 90 degrees flexion while maintaining internal rotation of tibia and then repeats while maintaining external rotation of tibia. Positive is click or pain

Question 31

Apley Grind test

Answer 31

For meniscus, Patient prone with knee flexed to 90 degrees. Examiner places downward pressure through foot while IR and ER tibia. Positive= pain

Question 32

Thessaly Test

Answer 32

For meniscus, Patient stands on affected leg while holding examiners hands. They then rotate their BODY and leg internally with knee bent 5 degrees and then 20 degrees. Positive with pain and or click in the knee.

Question 33

CPR patellofemeoral pain syndrome

Answer 33

≥ 2 degrees forefoot valgus ≤ 78 degrees of great toe extension ≤ 3mm navicular drop ≤ 5 degrees of valgus and any varus of relaxed calacaneal stance Tight hamstring muscles in the 90/90 SLR Reports of difficulty walking If top two are positive=post test probability of 86% with successful outcome with orthotics and activity modification

Question 34

Dorsiflexion Compression Maneuver

Answer 34

Syndesmosis pain -Patient in sitting -Examiner passively DF ankle with overpressure -Positive is pain along tib fib syndesmosis

Question 35

Dorsiflexion Compression Test

Answer 35

Patient in weight bearing lunge position Patient lunges to place ankle in full available DF Examiner notes location of pain and amount of DF with inclinometer Examiner applies medial-lateral compression and the test is repeated. Positive less pain at syndesmosis or increased ROM with second manuever

Question 36

Squeeze test

Answer 36

Examiner squeezes syndesmosis with one hand Positive=recreates pain

Question 37

Calcaneus tilt (talar tilt)

Answer 37

Patient in supine Lower leg is stabilized as examiner adducts calcaneus Positive = pain along lateral ankle

Question 38

Anterior Drawer test (ankle)

Answer 38

For ATFL, Patient in supine with hip and knee flexed to place foot on table and ankle in 10- 20 degrees plantar flexion Tibia is stabilized as heel is translated forward Movement compared to other side looking for asymmetry.

Question 39

Matles Test

Answer 39

For achilles rupture, Patient prone. Patient flexes knee to 90 degrees Positive test- foot assumes neutral or slight dorsiflexion

Question 40

Windlass Test

Answer 40

Plantar fasciitis, Patient seated with knee flexed to 90 degrees. Examiner stabilizes ankle and passively extends MTP joint while allowing IP to flex. Positive =pain and limited ROM

Question 41

Impingement Sign

Answer 41

For anterolateral impingement, Patient seated Examiner grasps calcaneus with one hand and places forefoot into plantar flexion Use opposite thumb to place pressure over the anterolateral ankle Foot is brought from plantar flexion to dorsiflexion maintaining pressure Positive more pain in Dorsiflexion than Plantar flexion

Question 42

Triple Compression Stress Test

Answer 42

Posterior tibial nerve. Full PF with inversion while placing pressure on posterior tibial nerve x 30 secs

Question 43

Posterior glide of knee

Answer 43

Improves knee flexion

Question 44

Anterior glide of knee

Answer 44

Improves knee extension

Question 45

Posterior glide of talus

Answer 45

Improves ankle dorsiflexion

Question 46

Anterior glide of talus

Answer 46

Improves ankle plantarflexion

Question 47

Lateral glide of calcaneus

Answer 47

Improves ankle inversion

Question 48

Medial glide of calcaneus

Answer 48

Improves ankle eversion

Question 49

Hip OA special tests

Answer 49

-FABER -Hip IR and flexion 15 degrees differ from uninvolved hip -Arthritis Cluster -Balance assessments -BERG -SLS

Question 50

avascular necrosis special tests

Answer 50

-Limited hip internal rotation, flexion, and abduction AROM and PROM

Question 51

Labral tear special tests

Answer 51

-IR-Flex-Axial Compression maneuver -FAIR -FADDIR -Posterior Labral Tear test -Thomas test

Question 52

Trochanteric bursitis special tests

Answer 52

- Pain with palpation greater trochanter

Question 53

Femoracetabular impingment special tests

Answer 53

-FADIR -Diagnosis dependent on history

Question 54

Obturator nerve entrapment clinical manifestations

Answer 54

-Pain with extension and ABD of the hip -decreased sensation obturator nerve distribution