Special Tests Flashcards
(18 cards)
Describe how you would carry out the Straight Leg Raise (SLR) Test and what a positive diagnoses indicates:
Disc Pathology / Nerve Root Irritation.
Patient lies supine and the leg is brought into passive hip flexion.
+ve = reproduction of pain or neuro symptoms.
Test(s) for Lx Radiculopathy?
SLR test
Bragard’s Sign
Describe how you would carry out the Femoral Nerve Tension Test and what a positive diagnoses indicates:
Femoral Nerve irritation or compression.
Patient lies prone and is brought into passive knee flexion then passive hip extension.
+ve = Reproduction of pain / neuro symptoms in anterior thigh.
Describe how you would carry out the Bragard’s Sign Test and what a positive diagnoses indicates:
Lx Nerve Root Irritation, most likely disc herniation.
The patient lies supine and examiner performs a passive SLR test until pain is felt, then the leg is brought just out of the range of pain and the ankle is passively dorsiflexed.
+ve = reproduction of pain.
The Double Leg Lowering Test (DLLT) assesses abdominal strength, why may this test be performed in relation to the the Lx Sp?
Poor abdominal strength may be contributing to the Lx sp. pain through poor posturing, the inability to brace for movements or general lack of support / imbalance.
Test(s) for Femoral Nerve irritation or compression?
Femoral Nerve Tension Test
Describe how you would carry out Waddell’s Sign and what a positive diagnoses indicates:
Tests for non-organic components of pain (biopsychosocial elements).
Split into 5 categories:
1 - Superficial & widespread non-specific tenderness.
2 - False Loading (Axial compression & Rotation)
3 - Distraction tests (pain reported on lying SLR but not seated)
4 - Non-anatomical sensory changes or weakness
5 - exaggerated responses which does not correlate with findings.
+ve = 3 or more /5 positive categories.
What is the most likely interpretation of the following results:
+ve SLR & -ve Bragard’s Sign
Likely muscle tightness or a non-neurological cause of pain.
Test(s) for Sciatic Nerve Tension?
Slump Test
Describe how you would carry out the Slump Test and what a positive diagnoses indicates:
Neural Tension of the Sciatic Nerve.
Patient SOEOB with hands behind their back, then a sequence of movements:
1 - Slump over and round the spine.
2 - Cx Flexion (chin tuck)
3 - Knee extension of either leg
4 - Dorsiflexion of outstretched leg
5 - Cx Extension (release)
+ve = pain, discomfort or recreation of symptoms during tension. Confirmed with easing of symptoms when Cx is released.
What special test findings would suggest to you that a patients symptoms are likely nerve root irritation or sciatica (e.g. lumbar disc herniation)?
+ve SLR & +ve Bragard’s Sign
What special test findings would suggest to you that a patients symptoms are likely non-nerve-related causes (e.g., muscle strain, joint issues, mechanical back pain)?
-ve SLR & -ve Bragard’s Sign
Test(s) for Abdominal Strength?
Double Leg Lowering Test (DLLT)
Test(s) for non-organic elements of pain (biopsychosocial involvements)?
Waddell Sign.
Describe how you would carry out the Double Leg Lowering Test (DLTT) and what a positive diagnoses indicates:
Abdominal Muscle Strength.
Patient lies supine with arms folded across their chest, examiner places fingers under Lx spine. Both legs are passively raised to 90*, instruct patient to lower legs whilst keeping pressure on the examiners finger.
+ve = assess the angle at which pressure is lost or control of the legs lowering stops.
The Femoral Nerve Tension Test is used to assess for irritation of the femoral nerve, from what spinal segments does this nerve originate?
L2-4.
Describe how you would carry out the Bowstring Sign Test and what a positive diagnoses indicates:
Lumbosacral Nerve Tension.
Patient supine lying performs passive SLR to the point of pain, then at the point of maximum pain flex the knee ~20* to alleviate symptoms. Then apply pressure onto the popliteal fossa on the sciatic nerve.
+ve = SLR pain recreated.
Test(s) for Lumbosacral Nerve Tension?
Bowstring Sign
