Special Tests Flashcards
Upper Quarter Screen
Vertebral artery test
Spurling’s test (quadrant test)
Distraction test
Vertebral artery test
Position: pt in supine or sitting.
Test: passively and fully extend and rotate cervical spine to one side.
(+): Pt reports tinnitus, dizziness, nausea, throbbing, confusion, or unusual sensation. Observe for pupillary dilation or constriction
Suggests: vertebral artery is compromised
Spurling’s Test
Position: pt in sitting
Test: Pt positioned in cervical extension, rotation, and ipsilateral side bending with overpressure
(+): reproduction of pt’s symptoms
Suggests: further examination for cervical radiculopathy, cervical disc prolapse, and neck pain
Distraction Test
Position: Pt lying in supine
Test: Pt’s neck flexed and about 14lbs distracted
(+): decrease in pt’s symptoms
Suggests: cervical radiculopathy
Lower quarter screen
Standing flexion test Gillet's test Long-sitting test Sitting flexion test SLR Prone knee bend (femoral nerve stretch) Slump test Centralization Phenomenon
Standing flexion test
Position: pt standing or sitting
Test: palpate B PSIS and ask pt to bend forward
(+): PSIS with non symmetrical movement.
Suggests: PSIS that moves cranially first or farthest is consisdered the involved side
Gillet’s test
Position: pt standing
Test: Palapate B PSIS. Pt stands on one leg and pulls the other toward the chest.
(+): the dysfunctioning joint will not move while the normal joint will move inferiorly
Suggests: Sacroiliac joint dysfunction
Long sitting test
Position: long sitting
Test: pt’s leg lengths observed lying supine, pt’s leg lengths observed long sitting.
(+): If the limb is longer than the other in supine but shorter when sitting, there is an anterior innominate rotation is on that side. If the limb is shorter in supine but longer while sitting, then a posterior innominate rotation is on that side.
Suggests: a rotated innominate based on the apparent leg length
Sitting flexion test
Position: pt seated with feet flat on the floor
Test: Palpate PSIS, pt bends forward with arms across chest
(+): blocked joint moves first or farther cranially
Suggests: sacroiliac dysfunction
SLR
Position: pt lying supine
Test: Passively raise 1 LE with knee extended
(+): pain extends from back down leg
Suggests: LBP and unilateral dysfunction of the SI joint
Prone knee bend test
Position: pt lying prone
Test: Pt flexes knee while clinical extends the hip
(+): pain to the lateral aspect of the hip into the upper lumbar spine or anterior thigh
Suggests: L1-3 nerve root lesion or femoral nerve neural tension
Slump test
Position: pt seated
Test: pt slumps into lumbar and thoracic flexion. Neck is flexed. One knee is extended. Same side foot is dorsiflexed.
(+): Reproduction of radicular pain
Suggests: lumbar spine disc herniation, neural tension, impaired neurodynamics
Centralization phenomenon
Symptoms centralize during single or repeated motions
Sacroiliac region screen
Distraction test Thigh thrust Gaenslen's test Sacral thrust Compression test
At least 3/5 (+) findings on these tests is indicative of SI joint pain
Distraction test
Position: pt lying supine
Test: examiner applies cross-arm pressure to both ASIS
(+): symptoms increase or are reproduced
Suggests: SI joint dysfunction
Thigh thrust
Position: pt lying supine hip flexed to 90
Test: examiner applies posteriorly directed force through the femur
(+): symptoms increase or are reproduced
Suggests: SI joint dysfunction
Gaenslen’s test
Position: pt lying supine near the edge of the table with one leg hanging over the edge
Test: contralateral leg flexed toward the chest. Examiner applies a firm pressure to both the hanging and flexed leg.
(+): symptoms increase or are reproduced
Suggests: SI joint dysfunction
Sacral thrust
Position: pt lying prone
Test: examiner applies a force vertically downward to the center of the sacrum
(+): symptoms increase or are reproduced
Suggests: SI joint dysfunction
Compression test
Position: pt in sidelying with affected side up
Test: hips are flexed to 45 and knees flexed to 90. Examiner applies force vertically downward on the ASIS
(+): symptoms increase or are reproduced
Suggests: SI joint dysfunction
Shoulder impingement tests
Neer’s test
Hawkins-Kennedy test
Painful arc
Rotator cuff tests
Supraspinatus muscle test Infraspinatus muscle test Drop arm test External rotation lag sign Internal rotation lag sign Lift off test Belly press test
Instability tests
Sulcus sign Anterior apprehension test Relocation test Anterior drawer test Jerk test for posterior instability
AC joint tests
Horizontal adduction test Resisted horizontal extension test O'Brien's sign Paxinos sign Palpation of AC joint
Labrum tests
Crank test Biceps load I test Biceps load II test Pain provocation test Compression rotation test O'Brien's active compression test Resisted supination external rotation test
