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5 Cards in this Set
- Front
- Back
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Trunk flexion test: for psoas shortness |
The patient lies supine without a pillow, arms folded across the chest. The patient is asked to slowly raise the head, the shoulders and the shoulder blades from the table. Normal: Ability to raise trunk until scapulae areoff table without feet lifting off the table or low back arching. Abnormal: If the feet rise, or low back arches,before the scapulae leave the table, psoas overactivity and weak abdominals are indicated (lower crossed syndrome, see above). |
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Hip abduction test |
The patient should be sidelying, with lower leg flexed and the upper leg in line with trunk. The patient is asked to abduct the leg slowly as the practitioner observes. Normal: Hip abduction to 45. Abnormal: If hip flexion occurs TFL shortnessis indicated; if the leg externally rotates piriformis shortening is indicated; if ‘hiking’ of the hip occurs at the outset of the movement quadratus lumborum is overactive and probably shortened. For direct palpation rather than observation, a fingerpad is placed on the lateral margin of quadratus lumborum. If quadratus fires strongly and first (before gluteus medius), this indicates overactivity and probable shortness of quadratus lumborum (observed as a ‘hip-hike’). |
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Prone hip extension test |
The patient lies prone and the practitioner palpates the lower erector spinae on both sides with one hand and gluteus maximus and the hamstrings with the other (see Fig. 16.11). The patient is asked to extend the leg at the hip. The normal activation sequence is gluteus maximus and hamstrings, followed by erector spinae (contralateral then ipsilateral). If the hamstrings and/ or the erectors fire first, they are working inappropriately, and will demonstrate shortness (see discussion of postural and phasic muscles earlier in this chapter). |
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Neck flexion test: Chin-Poke Assessment |
The patient lies supine without a pillow. Practitioner kneels to one side at the level of the patient’s chin as the patient is asked to ‘lift your head and put your chin on your chest’. Normal: Ability to comply with the request without chin-poking, and to hold chin tucked while flexing the head/neck for 10–15 seconds. Abnormal: If the chin pokes during neck flexion,or while maintaining this position for 10–15 seconds. The indication is of sternocleidomastoid and scalene tightness, with weakness of the deep neck flexors (see Fig. 16.9). There are many methods for gathering information by palpation and introduction of specific testing movements and activities. The skin palpation methods listed above and the functional assessments developed by Janda, however, offer very easily applied, non-invasive and non-stressful methods suitable for use in conditions such as FMS. Neuromuscular technique, in its assessment mode (below), offers another choice. |
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Scapulohumeral rhythm test |
This helps identify the status of the upper fixators of the shoulder. The patient is seated with the arm at the side, elbow flexed. The practitioner observes as the patient is asked to abduct the elbow towards the horizontal. Normal: Elevation of the shoulder after 60 of abduction. Abnormal: If obvious ‘bunching’ occurs between shoulder and neck, or winging of the scapulae occurs before 60 of abduction, this suggests levator scapulae and upper trapezius overactivity/shortness, and lower and middle trapezius and serratus anterior weakness – characteristics of the upper crossed syndrome (see above), commonly associated with respiratory dysfunction. |
