Column tests
Spring test
Patient position
Lying in prone and the neck in neutral position.
Therapist position:
The specialist is standing next to the patient at the head or side of the table, and places the hypothenar eminence of the hand over the spinous process of the segment to be tested.
Action of the test:
The examiner applies a gentle but firm, anteriorly-directed pressure on the spinous process of each vertebrae, to test the movement. This action must be repeated in each transverse process in order to test the rotation movement.
Positive result:
The stiffness at each segment is judged as normal, hypomobile, or hypermobile. Interpretation of whether a segment is hypomobile is based on the examiner’s anticipation of what normal mobility would feel like at that level and compared to the mobility detected in the segment above and below.
Special considerations:
Pain response to the applied force at each segment is judged as painful or not painful and if painful, whether the symptoms are local (i.e. under the examiner’s hand) or referred (away from the examiner’s hand).
The rotation movement must be compared with the rest of the vertebraes too.
Lasegue test
Patient position:
In supine position.
Position of the therapist:
Standing next to the patient, near the leg to test. One hand fixes the leg (close to the knee), and the other hand in the ankle.
Action of the test:
The terapist performs the manouvre by applying pressure to the piriformis muscle and his tendon, particularly when the hip is flexed at an angle of 90 degrees and the knee is extended.
Positive result:
It's positive when there is a sensation of pain .The pain or tenderness is often localized in the vicinity of the greater sciatic notch.
Kernig's test
Position of the patient:
Kernig's sign is assessed with the person lying supine.
Action of the test:
The patients flexes the hip and the knee to 90º actively.
Positive result:
In a person with a positive Kernig's sign, pain limits passive extension of the knee. A positive Brudzinski's sign occurs when flexion of the neck causes involuntary flexion of the knee and hip. Although Kernig's sign and Brudzinski's sign are both commonly used to screen for meningitis, the sensitivity of these tests is limited. They do, however, have very good specificity for meningitis: the signs rarely occur in other diseases.
Sacroiliac joint pressure test
The purpose of this test is to check the integrity of the posterior ligaments of the sacroiliac joint.
Patient position:
In lateral position.
Therapist position:
In his/her back, with his hands over the iliac crest to test.
Action of the test:
The therapist makes a pression downward.
Positive result:
Pain in the iliac crests.
Patrick-Fabere's Test
The purpose of this test is to detect the integrity of the hip or the sacroiliac joint.
Patient position:
Lying supine, with the hip flexed and abducted with the lateral ankle (malleolus) resting on the contralateral thigh just above (or proximal to) the knee.
Therapist position:
Standing next to the patient.
Action of the test:
While stabilizing the opposite side of the pelvis at the anterior superior iliac spine, an external rotation, abduction and posterior directed force is then slightly applied to the ipsilateral knee until the end range of motion is achieved. Further a couple of small-amplitude oscillations can be applied to check for pain provocation at the end range of motion.
Positive result:
A positive test is one that reproduces the patient's pain or limits their ROM.