Special Test Flashcards
(42 cards)
Slump Test
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
Straight Leg Raise
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
Prone Knee Bend
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
Bicycle Test
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
Thigh thrust
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
Sacral Thrust
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
Gaenslen’s
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
Distraction
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
Compression
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
Kinetic Test (aka Stork Test or Gillet’s Test)
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
FABER (aka Jansen’s Test)
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
Thomas Test
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
Modified Thomas Test
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
Sign of the Buttock
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.
Scour Test
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.
Noble Compression Test
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.
True Leg Length vs. Apparent Leg Length Testing
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
Thessaly Test
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
Valgus and Varus Stress Test
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
Swipe Test
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
Posterior Drawer Test for ankle
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
Squeeze Test
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)
External Rotation Test
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
Alar Ligament Rotation Test
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.
