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NAME OF TEST
Head compression
test
TESTING POSITION
sitting in neutral
PROCEDURE
POSITIVE TEST
apply vertical
downward force
INTEPRETATION
pain radiates to UE
Spurlings test
cervical radiculopathy
due to nerve root
compression
SAME AS ABOVE
SAME AS ABOVE
SAME AS ABOVE
SAME AS ABOVE
cervical radiculopathy
decrease symptoms
cervical radiculopathy
SHOULDER
1 (MEDIAN
NERVE,
ANTERIOR
INTEROSSEOUS
Depression
and abduction
(110 degree)
ELBOW
Extension
FOREARM
Supination
WRIST
Extension
FINGERS
AND
THUMB
Extension
SHOULD
ER
CERVICAL
Contralateral
side flexion
NERVE
2 (MEDIAN,
musculocutane
ous nerve,
axillary nerve
Depression
and abduction
(10 degree)
Extension
Supination
Extension
Extension
Lateral
rotation
Contralateral
side flexion
3 (RADIAL)
Depression
and abduction
(10 degree)
Extension
pronation
Flexion and
ulnar
deviation
Flexion
medial
rotation
Contralateral
side flexion
4 (ULNAR)
Depression
and abduction
(10-90 degree)
hand to ear
Flexion
Supination
Extension
and radial
deviation
Extension
Lateral
rotation
Contralateral
side flexion
2. Shoulder depression test for brachial plexus- Pt side flexed, PT gives pressure on shoulder, (+) pain on dermatome
III. LUMBAR SPECIAL TESTS
A. Nerve Root Impingement:
1. Valsalva Test:
Test Position:
Patient seated, examiner standing next to patient
Action:
Subject takes a deep breath and holds while bearing down as if having a bowel movement
Positive Finding:
Increased spinal or radicular pain due to intrathecal pressure
May be secondary to a space-occupying lesion (i.e. herniated disc, tumor, osteophyte in lumbar
canal)
Comments:
Increase in intrathecal pressure may result in pulse, venous return, venous pressure
(dizziness and/or fainting)
2. Milgram Test:
Test Position:
3. Kernigs Test:
Test Position:
Patient supine, examiner at side of patient
Action:
Patient performs a unilateral active straight leg raise with the knee extended until pain occurs
After pain occurs, the patient flexes the knee
Positive Finding:
Pain in the spine and possibly radiating into lower extremity
Pain relieved when patient flexes the knee
Implications:
Nerve root impingement secondary to bulging of the intervertebral disc or bony entrapment;
irritation of dural sheath; irritation of meninges
4. Kernig/Brudzinski Test:
Patient actively flexes the cervical spine (lifts the head)
Hip unilaterally flexed (no more than 900)
Knee than flexed to no more than 900
(+) pain with neck and hip flexion; pain relieved when knee is flexed
5. Unilateral Straight Leg Raise Test (Lasegue Test):
Test Position:
Patient supine, examiner standing at tested side with the distal hand around the subjects heel and
proximal hand on subjects distal thigh (anterior) maintains knee extension
Action:
Examiner slowly raises the leg until pain/tightness noted or full ROM is obtained
Slowly lower the leg until the pain or tightness resolves, at which point dorsiflex the ankle and have
subject flex the neck
Positive Findings:
Leg and/or low back pain occurring with DF and or neck flexion is indicative of dural involvement
and/or sciatic nerve irritation
Lack of pain reproduction with DF and/or neck flexion is indicative of hamstring tightness or SI
pathology
Test Position:
Patient supine
Examiner at feet of patient with hands cupping the calcaneous of each leg
Action:
Patient attempts to actively straight leg raise on the involved side
Positive Findings:
Patient does not attempt to lift the leg and examiner does NOT sense pressure from the uninvolved
leg pressing down on the hand
Patient is not attempting to perform the test
Chvosteks test
Bells phenomenon
Marcus Gunn
Marin Amat
Sciatic (tibial)
tibial
sural
common peroneal
flex
flex, add
flex
flex , IR
KNEE
extend
extend
extend
extend
flex
extend
DF
KNEE
flex
flex
extend
(+) sign
(+) pain=spondylolisthesis
(+) facet joint dysfunction
(+) DJD on lumbar spine
additional 5-10 cm flexion/extension
is normal
Maneuver
Finding
1. Gillets
standing
2. Flamingo
3. Gaenslens
unilateral standing
sidelying, bottom leg
flexed, test
(+) if no movement or
moves up
(+) sharp pain
(+) pain
(+) pain
or