Special Tests of The Spine 1

PTEVAL: SPECIAL TESTS FOR THE SPINE

PART ONE: SPECIAL TESTS OF THE CERVICAL SPINE
TESTS FOR CERVICAL MUSCLE STRENGTH
TYPE OF TEST PROCEDURE POSITIVE TEST SIGNIFICANCE ILLUSTRATION
Px: Supine with their knees bent (+) For deep cervical flexor muscle function
(crook lying) with head and neck in If pt. can’t increase pressure to at
midrange and an inflatable pressure least 26 mmHg
sensor is placed under the cervical
spine (Fig. 3-33) Unable to hold a contraction for 10
seconds, uses the superficial neck
PT: Ask pt. to flex their cervical spine muscles or extends the neck
CRANIOCERVICAL FLEXION
Inflate the pressure device to 20
TEST
mmHg to “fill in” the lordotic curve of
the cervical spine
Ask pt. to flex the cervical spine by

nodding the head in 5 graded

segments of increasing pressure
(22,24,26,28, and 30 mmHg)
TESTS FOR NEUROLOGICAL SYMPTOMS
Px: Sitting or standing (+) For patients who have complained of

If the pt. abducts the arms while radicular symptoms
PT: Place one hand under the pt.’s traction is applied, the symptoms are
chin and the other hand around the often further relieved or lessened in Used to alleviate symptoms
occiput, then slowly lifts the pt.’s head the shoulder, especially if C4 or C5
(Fig. 3-35) applying traction to the nerve roots are involved Checking radicular signs referred to the
cervical spine shoulder complex anteriorly or posteriorly
DISTRACTION TEST
Increased pain on distraction =
muscle spasm, ligament sprain,
muscle strain, dural irritability or disc
herniation
Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 1

Px: Bends or side flexes the head to (+) Performed if the pt. has complained of
the unaffected side first then the Pain radiates into the arm toward nerve root symptoms which at the time
affected side which the head side flexed during of the examination are diminished or
PT: Carefully press straight down the compression = pressure on a nerve absent
head (Fig. 3-36) root (cervical radiculitis)
Designed to provoke symptoms
**Doing this test in 3 stages = first *Radiculitis = pain in the dermatomal
(compression with head in neutral), distribution of the nerve root affected Stenosis, cervical spondylosis,
FORAMINAL COMPRESSION
second ( compression with head in osteophytes, trophic, arthritic, or inflamed
TEST
extension and rotation to the (-) facet joints, herniated disc or vertebral
(SPURLING’S TEST)
unaffected side then to affected side), Neck pain with no radiation into the fractures
third (follows the test itself) shoulder or arm

*Reverse Spurling’s Sign - pain is
felt at the OPPOSITE side to which
the head is taken; indicative of muscle
spasm (in tension myalgia and WADs)
Px: Slide flexes the head and then (+) Nerve root or facet joint pathology or
rotates it to the same side and Pain radiates into the arm muscle strain
repeated to the other side (Fig. 3-37)
Pain on the concave side = nerve
**May also compress the vertebral root or facet joint pathology
artery. If one is testing the vertebral Pain on the convex side = muscle
artery, the position should be held for strain
20 to 30 seconds to elicit symptoms
(e.g., dizziness, nystagmus, feeling
faint, nausea) that would indicate
MAXIMUM CERVICAL compression of the vertebral artery
COMPRESSION TEST

Modification of the foraminal (+) Pressure on a nerve root

compression test Pain radiates into the arm
*Pain distribution can give some
Px: Rotates the head to one side indication on which nerve root is
affected
PT: Carefully presses straight down
on the head (Fig. 3-38). Repeat with
the head rotated to the other side
JACKSON’S COMPRESSION
TEST
Px: Sitting or lying down **Bakody’s Sign - a decrease in For radicular symptoms, especially those
or relief of symptoms = cervical involving the C4 or C5 nerve roots
PT: Passively or the pt. actively extradural compression problem,
elevates the arm through abduction =
such as a herniated disc, epidural
hand or forearm rests on top of the
head (Fig. 3-39) vein compression, or nerve root
compression, usually in the C4–C5
or C5–C6 area
**Abduction of the arm decreases

the length of the neurological
SHOULDER ABDUCTION pathway and decreases the
(RELIEF) TEST pressure on the lower nerve roots
**If the pain increases with the

positioning of the arm = pressure
is increasing in the interscalene
triangle

Equivalent to the straight leg (SLR)

test in the lumbar spine
Px: Supine (ALL)
ULNT1 (A)
Shoulder: Depress and abduct
Forearm: Supinate
Elbow: Extend
Wrist, Fingers and Thumb: Extend
Instruct pt. to perform contralateral

cervical side flexion
ULNT2 (B)
Shoulder: Depress and abduct
Forearm: Supinate
Elbow: Extend
Wrist, Fingers and Thumb: Extend
UPPER LIMB Instruct pt. to perform contralateral

NEURODYNAMIC (TENSION) cervical side flexion
TESTS BRACHIAL PLEXUS
TENSION OR ELVEY TEST ULNT 3 (C)
Shoulder: Depress and abduct (110°)
medial rotate
Forearm: Pronate

Elbow: Extend
Wrist, Fingers and Thumb: Flex and
ulnar deviate

ULNT 4 (D)
Shoulder: Depresses and abduct

(10-90°) (hand to ear), medial rotate
Forearm: Supine/pronate
Elbow: Extend
Wrist, Finger and Thumb: Extension
and radial deviate




Px: Sitting (+) This test is

PT: Abducts arms with elbows Reproduction of radicular symptoms similar to ULNT4 and stresses primarily
extended, stopping just short of sxs with elbow flexion = ulnar nerve and the ulnar nerve and the C8 and T1 nerve
→ ER the shoulder → just short of C8 and T1 nerve roots roots.
sxs → examiner holds position → px.
flexes the elbow
BRACHIAL PLEXUS TENSION

TEST
PT: Applies firm compression to the Pain at the site is not diagnostic. It is positive for mechanical cervical
brachial plexus by squeezing the (+) lesions having a mechanical component.
plexus under the thumb or fingers. Pain radiates into the shoulder or
upper extremity.

BRACHIAL PLEXUS
COMPRESSION TEST
Px: Ask px to take a deep breath & (+) Determine effect in increased pressure on
hold while bearing down Increased pain = ↑intrathecal pressure the spinal cord NO PICTURE
VALSALVA TEST
Don’t do with hypertensive pt. Cervical Myelopathies

TESTS FOR UMNL
Px: Long leg sitting position on the (+) Test for the spinal cord itself and a
examining table. Sharp, electric shock-like pain down possible upper motor neuron lesion.
PT: Passively flexes the patient’s the spine and into the upper or lower
head and one hip simultaneously with limbs; it indicates dural or meningeal
the leg kept straight (Figure 3-45). irritation in the spine or possible
cervical myelopathy
Coughing or sneezing may produce

similar results.

LHERMITTE SIGN
Px: Actively flexes the head to the (+) Test for the spinal cord itself and a
chest while in the supine lying position Sharp, electric shock-like pain down possible upper motor neuron lesion.
the spine and into the upper or lower NO PICTURE
SOTO-HALL TEST
If the hips are flexed to 135°, greater limbs; it indicates dural or meningeal
traction is placed on the spinal cord irritation in the spine or possible
cervical myelopathy

Px: Standing and is asked to close the (+) Upper Motor Neuron Lesion
eyes. The position is held for 20 to 30 Body begins to sway excessively or
seconds. the px. loses balance
ROMBERG TEST

TESTS FOR VASCULAR SIGN
Part 1 (+) Used to differentiate dizziness or vertigo

Px: Sits and forward flexes both arms If the arms move, the cause is caused by articular problems from that
to 90° (Figure 3-46). The eyes are nonvascular. caused by vascular problems
then closed.
PT: The examiner watches for any (+)
loss of arm position. If wavering of the arms occurs, the
Part 2 dysfunction is caused by vascular
Px: The patient is then asked to impairment to the brain.
rotate, or extend and rotate, the neck;
HAUTANT’S TEST this position is held while the eyes are
again closed.
Each position should be held for 10 to

30 seconds.

Px: Seated Pain may indicate a nerve root N/A

PT: Stands behind the patient with his problem or space occupying lesion
or her fingers over the patient’s jugular (e.g., tumor).
veins (Figure 3-47). The examiner
compresses the veins for 30 seconds If lightheadedness or similar
symptoms occur with compression of
(Naffziger recommended 10 minutes!) the jugular veins, the test should be
NAFFZIGER TEST and then asks the px to cough. terminated.
Px: Supine (+) Vertebral artery Compression:

PT: Passively takes pt. Neck and Provokes referring symptoms if Dizziness or Nystagmus occurs
head into extension and side flexion. opposite artery is affected
PT then rotates the pt.’s neck to the
same side and holds it for approx. 30
secs
VERTEBRAL ARTERY TEST
Similar function as VAT: (+) Assesses nerve root compression

Involves extension + rotation instead Provokes referring symptoms if
DEKLEYN-NIUWENHUYSE of extension + Side flexion opposite artery is affected
TEST To Test the Upper Cervical Spine: NO PICTURE
PT: Pokes pt. Chin and follows
Extension, Side Flexion, Rotation


TESTS FOR BPPV
Px: Long sitting, Head rotated approx. (+) BPPV

30 to 40 degrees Signs of Dizziness and Nystagmus (Benign Paroxysmal Positional Vertigo)
PT: Behind pt. One hand supports the
head and neck while other hand
support the trunk. Pt. is then assisted
to supine position. Head is slightly
below horizontal plane. Position is
then maintained for 30 to 60 secs

DIX-HALLPIKE MANEUVER

TESTS FOR CERVICAL INSTABILITY
Px: Supine with head in neutral Nystagmus, Pupil changes, Dizziness, Tests Integrity of the supporting
position resting on the bed Nausea, Facial or Lip Paresthesia, ligamentous and capsular tissues of the
PT: Applies anterior directed force Lump sensation on the throat cervical spine
through the posterior arch of C1 or the
spinous processes of C2 → T1 or
ANTERIOR SHEAR bilat. Through the lamina of each
(SAGITTAL STRESS TEST) vertebral body

Px: Supine with head supported Normally Painful because of the Atlantoaxial instability caused by odontoid
PT: Place radial side of the 2nd MCP compression of soft tissues against dysplasia
Joint of one hand against TV Process the bone
of the Atlas and the MCP Joint of the
other hand against the TV Process of
the atlas and the MCP Joint
Examiner’s hands are then carefully

pushed together which causes shear
of bone on the other bone
LATERAL SHEAR TEST
SHOULD BE PERFORMED WITH (+) Atlas Subluxation on Axis

EXTREME CAUTION! Examiner feels the head slide
backward during the movement
PT: Examiner places one head over Slide may be accompanied by a clunk
the pt.’s forehead. Thumb of the other
hand is placed over the spinous
process of the axis to stabilize it. Pt. is
then asked to slowly flex the head.
Examiner presses backward with the
palm
SHARP-PURSER TEST


TESTS FOR NEUROLOGIC INVOLVEMENT
SLT-1: (+) Dura and Spinal Cord or Nerve root

Px: pt. Sits(Long sitting) on examining Sciatic pain or reproduction of pt. sx Impingements
table, hands behind the back, and
asked to slump so that the spine
flexes and the shoulders sag forward
PT: Holds the chin and head erect
Use other arm to apply overpressure
across the shoulders to maintain
flexion of the thoracic and lumbar
spines

If no symptoms are produced:
PT: Flexes the pt.’s neck and
shoulders slumped

PT: Passively extend knees

PT: Passively dorsiflex foot
SLUMP TEST Do all tests in the other leg, and then

both legs
If pt cannot extend the knee due to

pain,
PT: release overpressure to the
cervical spine and make pt. Extend
his/her neck

MODIFICATIONS:
SEQUENCE:
ST-1:

Cervical Spine: Flexion
Thoracic and Lumbar Spine:
Flexion(Slump)
Hip: Flexion
Knee: Extension
Ankle: Dorsiflexion
Nerve Bias: SC, Cervical and Lumbar
Nerve roots, Sciatic Nerve

ST-2:

Flexion(Slump)
Hip: Flexion (90), abduction
Knee: Extension
Ankle: Dorsiflexion
Nerve Bias: Obturator nerve

ST-3:
(Side Lying Slump)

Flexion(Slump)
Hip: Flexion (20)
Knee: Flexion
Ankle: Plantar flexion
Nerve Bias: Femoral Nerve

ST-4:
(Long Sitting Slump)

Cervical Spine: Flexion, Rotation
Flexion(Slump)
Hip: Flexion (90)
Knee: Extension
Ankle: Dorsiflexion
Nerve Bias: SC, Cervical and Lumbar
Nerve roots, Sciatic Nerve



MODIFICATIONS

ST-1


ST-2

ST-3


ST-4


PART TWO: SPECIAL TESTS OF THE THORACIC AND LUMBAR SPINE
TESTS FOR NEUROLOGIC INVOLVEMENT
Px: Stands one leg and raises heel (+) A weak gluteus medius muscle or a coxa
if nostance side ilium drops down vara (abnormal shaft-neck angle of the
instead of elevating as it normally femur) on the stance leg side may
would produce a positive sign.
TRENDELENBURG TEST If the patient is unable to complete the
movement by going up and down on
the toes, the examiner should suspect
an S1 nerve root lesion.

Px: =prone position w/ head straight (+) Damage to inf gluteal nerve or pressure
and arms by the side If affected side shows less contraction on L5 S1 or S2 nerve roots
or may be atonic and remain flat

PT: Stands at the pt’s feet and
observes the buttocks from the level of NO PICTURE
GLUTEAL SKYLINE TEST
the buttocks.
Px is asked to contract gluteal

muscles
Affected gmax appears flat due to
atrophy

Px: supine with hands cupped behind (+) i f pain disappears (+) test may indicate meningeal irritation,
the head nerve root involvement, or dural irratation.
PT: instructs px to flex the head onto

chest.
Px actively raises the extended leg by

flexing the hip until pain is felt
Px then flexed the knee
BRUDZINSKI-KERNIG TESTt
Px: Prone (+) unilateral neurological pain in the L2 or L3 nerve lesion

lumbar area, buttock, post thigh or ant
PT: passively flexes knee as far as thigh may indicate an L2 or L3 nerve
possible so px’s heel rests against lesion
buttock. Ensure that hip is not rotated.
Pain in ant thigh may indicate tight
If unable to flex past 90o because of quads or stretching of femoral nerve
PRONE KNEE BENDING pathological condition in the knee, test
TEST may be performed by passive ext of
the hip while knee is flexed as much
as possible



Px: Supine, hip in IR and adducted, Pain primarily in the back = disc
and knee extended herniation
STRAIGHT LEG RAISE PT: flexes hip until the px complains of Pain primarily in the leg = pathology
pain or tightness in the back or back of is more lateral
Lasegue’s Test the leg
PT drops leg until loss of sxs, then to
provocate sxs, px is asked to flex neck
and dorsiflex foot


TESTS FOR LUMBAR SPINE INSTABILITY
Px: lies prone (+) if px complains of pain in the N/A

lumbar area when in extended
PT: passively lifts and extends both position, and disappears when legs
extremities at the same time to about are lowered to starting position
PASSIVE LUMBAR 1 foot(30cm) from bed.
EXTENSION TEST Numbness or prickling sensation are
While maintaining position, gently pull not positive signs
legs
Px: Lies prone (+) if px feels pain in the leg Indicates an unstable segment
PT: with one hand, apply pressure to

post aspect of lumbar spine, with the
other hand, passively flex the px’s
knees until heels touch the buttocks
PHEASANT TEST

Px: Prone with the body on the (+) Likelihood of a patient with low back pain
examining table and the legs over the If pain is elicited in the resting position responding to a stabilization exercise
edge resting on the floor. (Fig. 9-76) only because the muscle action masks program.
the instability.
PT: The examiner applies pressure to
the posterior aspect of the lumbar
PRONE SEGMENTAL spine while the patient rests in this
INSTABILITY TEST position.
The patient then lifts the legs off the

floor, and the examiner again applies
posterior compression to the lumbar
spine.

LUMBAR SPINE JOINT DYSFUNCTION
Px: Stands with the examiner standing (+) Indicates whether the symptoms are
to one side. Increased neurological symptoms on actually causing the scoliosis.
the affected side.
PT: The examiner grasps the patient’s
pelvis with both hands and places a
shoulder against the patient’s lower
thorax. Using the shoulder as a block,
the examiner pulls the pelvis toward
the examiner’s body (Fig. 9-80).
MCKENZIE SLIDE GLIDE The position is held for 10 to 15

TEST seconds, and then the test is repeated
on the opposite side
If the patient has an evident scoliosis,

the side to which the scoliosis curves
should be tested first.

Px: Stands on one leg and extends (+) If the stress fracture is unilateral, standing
the spine while balancing on the leg Pain in the back and is associated on the ipsilateral leg causes more pain.
(Fig. 9-81). with a pars interarticularis stress
fracture (spondylolisthesis). If rotation is combined with extension and
The test is repeated with the patient pain results, this indicates possible facet
standing on the opposite leg. joint pathology on the side to which
rotation occurs.
STORK STANDING TEST
A point is marked midway between the (+) May be used to measure the amount of
two PSISs, which is the level of S2; N/A flexion occurring in the lumbar spine.
then, points 5 cm (2 inches) below and
10 cm (4 inches) above that level are
marked. The distance between the
three points is measured, the px is
asked to flex forward, and the distance
is remeasured.
SCHOBER’S TEST
The difference between the two
measurements indicates the amount
of flexion occurring in the lumbar
spine.
After completion of the flexion

movement, the patient extends the
spine, and the distance between the
marks is noted.


TEST FOR CLAUDICATION
Px: Seated on an exercise bicycle and (+) The test determines whether the patient
is asked to pedal against resistance. 1st Part: If pain into the buttock and has neurogenic intermittent claudication.
posterior thigh occurs, followed by
1st Part: The patient starts pedaling tingling in the affected lower extremity.
while leaning backward to accentuate
the lumbar lordosis (Figure 9-83). 2nd Part: If the pain subsides over a
BICYCLE TEST OF VAN short period of time.
GELDEREN 2nd Part: The patient is then asked to
lean forward while continuing to pedal. If the patient sits upright again, the
pain returns.
Px: Walks briskly (+) Performed to assess neurogenic

Pain ensues in the buttock and lower intermittent claudication, to determine
limb within a distance of 50 m (165 whether a relation exists among
feet). neurogenic symptoms, posture, and
walking. NO PICTURE
Pain relief:
The patient flexes forward.
The patient is sitting and forward
STOOP TEST
flexing.
(-)
If flexion does not relieve the
symptoms.
Extension may also be used to bring

the symptoms back.


TESTS FOR MALINGERING
Px: The patient is asked to kneel on a (+) Patient is malingering

chair and then bend forward to touch Patient is unable to perform the test or
the floor with the fingers (Fig. 9-84) the patient overbalances
BURNS TEST
Px: Supine If the patient does not lift the leg or Patient is malingering
the examiner does not feel pressure
PT: The examiner places one hand under the opposite heel, the patient is
under each calcaneus while the probably not really trying or may be a
patient’s legs remain relaxed on the malingerer.
examining table.
If the lifted limb is weaker, however,
The patient is then asked to lift one leg pressure under the normal heel
off the table, keeping the knees increases, because of the increased
HOOVER TEST straight, as for active effort to lift the weak leg. The two
straight leg raising. sides are compared for differences



PART THREE: SPECIAL TESTS OF THE PELVIS
OBSERVATIONAL TESTS
Px: Standing (+) Indication of an upslip of the ilium on the

If the ASIS and PSIS on one side are sacrum on the high side, a short leg on
PT: Palpate the patient’s ASIS and higher than the ASIS and PSIS on the the opposite side, or muscle spasm
PSIS, checking if the ASIS are leveled other side caused by lumbar pathology
PELVIC UPSLIP (same with PSIS)
(+) Anterior torsion of the sacrum

If the ASIS is higher on one side and (pathological nutation) on that side
the PSIS is lower at the same time
This torsion may result in a spinal scoliosis
PELVIC TORSION
or an altered functional leg length, or both


STRESS TESTS OF THE SI JOINT
Px: Supine (+) Indication of a sprain of the anterior

Test is positive only if unilateral gluteal sacroiliac ligaments
PT: Examiner applies crossed-arm or posterior leg pain is produced
pressure to the ASIS. Then pushes
down and out with the arms
GAPPING TEST

Px: Sidelying (+) SI lesion or Posterior SI sprain

PT: Hands are over the iliac crest and Pressure on SI joint
pressing downward
APPROXIMATION TEST
Px: Supine (+) SI Sprain

PT: The examiner flexes the patient’s Pain in the sacroiliac joints indicates a
knee and hip fully and then adducts positive test.
the hip.
SACROILIAC ROCKING
(KNEE TO SHOULDER TEST)
This test is also called the
sacrotuberous ligament stress
test.

Px & PT: The patient lies supine while (+) SI Sprain

the examiner passively flexes the hip Pain in the sacroiliac joint on thrusting
on the test side to 90°. Using one is a positive test.
hand to palpate the sacroiliac joint, the
examiner thrusts down through the
knee and hip on the text side (Fig
10-35)
THIGH THRUST TEST

TESTS FOR NEUROLOGIC DYSFUNCTION
Px: Patient actively lifts the leg, the (+) Possible sacroiliac joint problems
examiner asks whether the patient If the pain decreases or the SLR is
notes any “effort differences” between easier to do with form closure, the test
the two sides. is positive
PT: The examiner then stabilizes and
compresses the pelvis while the
patient actively does the straight leg
raise providing form closure of the
joints by squeezing the innominate
bones together anteriorly
SUPINE ACTIVE STRAIGHT
LEG RAISE (SLR) TEST **Another modification test force
closure at SI joints:
PT: The patient is asked to flex and

rotate the trunk toward the side that
the SLR is actively being performed.
The trunk motion is resisted by the
examiner.

The first condition is hip extension (+) Possible sacroiliac joint problems
If the pain decreases or the SLR is
The second condition includes the easier to do with form closure, the test
same movement as the first with the is positive
examiner applying manual
compression to the innominate bones
The third condition has the examiner

resisting extension of the contralateral
medially rotated arm as the patient
PRONE ACTIVE STRAIGHT
extends the straight (Fig. 10-39, C)
LEG (SLR) TEST


TEST FOR SI JOINT DYSFUNCTION
Px: stand in one leg, weight of the (+) Test to determine how well can px stand
trunk cause Pain in the symphysis pubis or on one leg. It is a good tool for balance
the sacrum to shift forward and distally sacroiliac joint
(caudally) with forward rotation.The = lesion on painful area
ilium moves in the opposite direction.
On the non–weight-bearing side, the

opposite occurs, but the stress is
FLAMINGO TEST greatest on the stance side

Px: side lying with the upper leg (test Pain For ipsilateral sacroiliac joint lesion, hip
leg) hyperextended at the hip. (A) = ipsilateral sacroiliac joint lesion, hip pathology or L4 nerve root lesion.
Px: holds the lower leg flexed against pathology, or an L4 nerve root lesion.
the chest. The test functions by stressing the tissues
PT: examiner stabilizes the pelvis on the posterior side of the pelvis and
while extending the hip of the creating motion at the sacroiliac joint.
uppermost leg.
Px: sometimes the position is supine.

but may limit the amount of
hyperextension available (B) Pain in the sacroiliac joint
Patient draws both legs up onto the

chest and then slowly lowers the test
GAENSLEN’S TEST leg into extension. The other leg is
tested in a similar fashion for
comparison


Px: standing If the SI joint on the side This test is used to determine if
PT: palpate the PSIS with one thumb on which the knee is flexed (i.e., the restrictions are present in the sacroiliac
and other thumb is parallel on sacrum ipsilateral side) moves minimally or up, joint.
the joint is said to be hypomobile,
Ask pt to stand on one leg while or “blocked,” indicates positive test.
pulling opposite knee up toward chest
Normal side, the test PSIS moves
down or inferiorly
GILLET’S TEST
(ipsilateral posterior rotation
test); ( sacral fixation test)


If so, it is believed that there is a
functional leg length difference
Px:supine with legs straight resulting from a pelvic dysfunction This test can help in differentiating
PT: examiner ensure that the medial caused by pelvic torsion or rotation. between a true leg length discrepancy and
malleoli are level sacroiliac dysfunction
It may also be caused by spasm of the
patient is asked to sit up, and the lumbar muscles in the presence
SUPINE TO SIT ( long sitting) examiner observes whether one leg of lumbar pathology.
TEST moves up (proximally) farther than the
other


Determine if SI joint pathology is present

and indicates iliopsoas or quads muscle
contracture

Pain localized to the sacroiliac joint=
pathology in the anterior sacroiliac
Px: prone ligaments.
YEOMAN’S TEST PT: examiner flexes the patient’s knee
to 90 degrees and extends hip Lumbar pain= lumbar involvement

Anterior thigh paresthesia= femoral
nerve stretch
OTHER TESTS OF THE PELVIS
TYPE OF TEST PROCEDURE POSITIVE TEST SIGNIFICANCE
If problem in the lumbar spine or helps to determine whether a patient’s

Px: supine hamstring, hip flexion increases buttocks pain has its origin in the buttock
PT: examiner performs a passive indicates negative sign of buttock test as a local lesion or is referred from the hip,
unilateral SLR test as done sciatic nerve or hamstring muscles.
Previously hip flexion does not increase when the
knee is flexed, it is a positive sign of
If restriction or pain is found the buttock test = bursitis, tumor, or To determine the possibility of
on one side, the examiner flexes the abscess non-musculoskeletal causes for the
SIGN OF THE BUTTOCK patient’s knee while holding the patient's symptoms
patient’s thigh in the same position. May exhibit non capsular pattern of
hip
Once the knee is flexed, the examiner
tries to flex the hip further.


Special Tests of The Spine 1

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PTEVAL: SPECIAL TESTS FOR THE SPINE

TESTS FOR CERVICAL MUSCLE STRENGTH

TYPE OF TEST PROCEDURE POSITIVE TEST SIGNIFICANCE ILLUSTRATION

Ask pt. to flex the cervical spine by

TESTS FOR NEUROLOGICAL SYMPTOMS

TYPE OF TEST PROCEDURE POSITIVE TEST SIGNIFICANCE ILLUSTRATION

Px: ​Sitting or standing (+) For patients who have complained of

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 1

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 2

Modification of the ​foraminal (+) Pressure on a nerve root

**Abduction of the arm decreases

**If the pain increases with the

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 3

Equivalent to the ​straight leg (SLR)

Px:​ Supine (ALL)

Instruct pt. to perform contralateral

UPPER LIMB Instruct pt. to perform contralateral

Instruct pt. to perform contralateral

Instruct pt. to perform contralateral

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 4

Px:​ Sitting (+) This test is

BRACHIAL PLEXUS TENSION

TESTS FOR UMNL

TYPE OF TEST PROCEDURE POSITIVE TEST SIGNIFICANCE ILLUSTRATION

Coughing or sneezing may produce

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 6

TESTS FOR VASCULAR SIGN

TYPE OF TEST PROCEDURE POSITIVE TEST SIGNIFICANCE ILLUSTRATION

Part 1 (+) Used to differentiate dizziness or vertigo

​Each position should be held for 10 to

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 7

Px:​ Seated Pain may indicate a nerve root N/A

Px: ​Supine (+) Vertebral artery Compression:

VERTEBRAL ARTERY TEST

Similar function as VAT: (+) Assesses nerve root compression

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 8

TESTS FOR BPPV

TYPE OF TEST PROCEDURE POSITIVE TEST SIGNIFICANCE ILLUSTRATION

Px: ​Long sitting, Head rotated approx. (+) BPPV

TESTS FOR CERVICAL INSTABILITY

TYPE OF TEST PROCEDURE POSITIVE TEST SIGNIFICANCE ILLUSTRATION

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 9

Examiner’s hands are then carefully

SHOULD BE PERFORMED WITH (+) Atlas Subluxation on Axis

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 10

TESTS FOR NEUROLOGIC INVOLVEMENT

TYPE OF TEST PROCEDURE POSITIVE TEST SIGNIFICANCE ILLUSTRATION

SLT-1: (+) Dura and Spinal Cord or Nerve root

SLUMP TEST Do all tests in the other leg, and then

If pt cannot extend the knee due to

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 11

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 12

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 13

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 14

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 15

PART TWO: SPECIAL TESTS OF THE THORACIC AND LUMBAR SPINE

TESTS FOR NEUROLOGIC INVOLVEMENT

TYPE OF TEST PROCEDURE POSITIVE TEST SIGNIFICANCE ILLUSTRATION

Px is asked to contract gluteal

Transcribers: Jiongco, C. | Lobrigo, C. | Lucena, P. | Santos, M. | Tobias, Y, | Vasco, A. | Yu, D. PTEVAL 16

PT: ​instructs px to flex the head onto

Px actively raises the extended leg by

Px: Sitting or standing (+) For patients who have complained of

Modification of the foraminal (+) Pressure on a nerve root

Equivalent to the straight leg (SLR)

Px: Supine (ALL)

Px: Sitting (+) This test is

Each position should be held for 10 to

Px: Seated Pain may indicate a nerve root N/A

Px: Supine (+) Vertebral artery Compression:

Px: Long sitting, Head rotated approx. (+) BPPV

PT: instructs px to flex the head onto

Px: Prone (+) unilateral neurological pain in the L2 or L3 nerve lesion

Px: lies prone (+) if px complains of pain in the N/A

PT: with one hand, apply pressure to

Px: Walks briskly (+) Performed to assess neurogenic

Px: The patient is asked to kneel on a (+) Patient is malingering

Px: Standing (+) Indication of an upslip of the ilium on the

Px: Supine (+) Indication of a sprain of the anterior

Px: Sidelying (+) SI lesion or Posterior SI sprain

Px: Supine (+) SI Sprain

Px & PT: The patient lies supine while (+) SI Sprain

PT: The patient is asked to flex and

Px: sometimes the position is supine.