Spine Special Tests: Weber-Barstow Maneuver Test
Spine Special Tests: Weber-Barstow Maneuver Test
Spine Special Tests: Weber-Barstow Maneuver Test
Special Tests
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Gaenslen's Test
Steps
Athlete is supine, lying close to the side of the table
Examiner allows the near leg to hang over the side edge of the table
Examiner instructs the athlete to actively flex the other leg to his/her chest & hold
Examiner stabilizes the athlete & applies pressure to the near leg, forcing it into
hyperextension
Positive Test
Pain in the SI region
Positive Test Implications
SI joint dysfunction
See Test
Fulcrum's Test
Steps
Athlete is seated with his/her knees bent at the end of the table
Examiner places his/her forearm or a similar bolster underneath of the athlete's mid–thigh
Examiner uses other hand to forcefully push down on the athlete's distal anterior thigh
Positive Test
Athlete experiences pain in his/her thigh
Positive Test Implications
Possible femoral stress fracture
Torque Test
Steps
Patient lies supine & close to the edge of the table so that the involved leg can abduct
over the edge of the table
Examiner passively extends the involved hip (with his/her hand supporting at the ankle)
until the pelvis begins to rotate anteriorly
Examiner then medially rotates the hip to EROM and then places a posterolateral force at
the hip joint in an attempt to distract it
Positive Test
Groin or lateral hip pain
Positive Test Implications
Sprain of the coxofemoral joint capsule or supporting ligaments
See Test
Gillet's Test
Steps
Athlete is standing with his/her PSISs visible
Examiner palpates the athlete's PSISs
Examiner has the athlete pull one knee towards his/her chest & hold while examiner
observes PSISs
Positive Test
Restricted side moves very little; unilateral stance is painful on the involved side
Positive Test Implications
SI joint pathology
See Test
SI Compression Test
Steps
Athlete is supine
Examiner applies pressure to spread the ASIS
Positive Test
Pain arising from the SI joint
Positive Test Implications
SI pathology
See Test
SI Distraction Test
Steps
Athlete is in the side–lying position
Examiner is positioned behind the athlete with both hands over the lateral aspect of the
pelvis
Examiner applies downward pressure through the anterior portion of the ilium, spreading
the SI joints
Positive Test
Pain through the SI joint
Positive Test Implications
SI pathology
See Test
Ely's Test
Steps
Athlete lies prone with the knees extended
Examiner passively flexes the athlete's knee
Positive Test
The hip on the same side passively flexes as the examiner flexes the knee
Positive Test Implications
Rectus femoris tightness
See Test
Thomas's Test
Steps
Athlete is supine with his/her knees bent at the end of the table
Examiner places one hand between the lumbar lordotic curve & the tabletop
Examiner passively flexes one of the athlete's legs to his/her chest, allowing the knee to
flex during the movement
Examiner observes the involved leg for movement
Positive Test
The knee of the leg on the table cannot flex past 90° (i.e. the knee of the leg on the table
will extend as the examiner flexes the contralateral hip); the involved leg (i.e. the leg on
the table) rises up off the table (i.e. the contralateral hip to the one being moved will flex)
Positive Test Implications
Rectus femoris tightness (the knee extends as the examiner flexes the hip); iliopsoas
tightness (the leg on the table will rise off of the table)
See Test
Trendelenburg's Test
Steps
Athlete stands with the feet evenly distributed (i.e. approximately shoulder–width apart
from each other)
Examiner sits or kneels behind the athlete
Examiner slightly lowers the athlete's shorts so that the examiner may palpate the right &
left PSIS and/or iliac crests
Examiner instructs the athlete to flex the hip thereby lifting the right (and then the left
knee) while observing the pelvis
Positive Test
The PSIS or iliac crest on the same side as the leg lifted will drop in relation to the
contralateral side
Positive Test Implications
Contralateral (i.e., stance leg) gluteus medius (hip abductor) weakness or decreased
innervation of the same muscles
See Test
Valsalva Test
Steps
With subject sitting examiner asks subject to take a deep breath and blow against closed
glottis (as if trying to have a bowel movement)
This increases intrathecal pressure
Positive Test
Pain or neurologic symptoms in buttox and thigh
Positive Test Implications
Herniated disc, abdominal trauma, tumor, or osteophyte in lumber canal
See Test
Oppenhiem Test
Steps
Run metal edge of neurlogic hammer, or fingernail along the tibial crest
Positive Test
Great toe extension with flexion and splaying of the lateral four toes
Positive Test Implications
Upper motor neuron lesion
See Test
Bowstring Test
Steps
Subject begins supine with legs extended
Examiner performs a passive straight leg raise on the involved side
If radiating pain is reported, the examiner then flexes the subjects knee until symptoms
are reduced
The examiner then applies pressure to the popliteal area in attempt to reproduce the
radicular pain
Positive Test
Reproduction of radicular pain with popliteal compression
Positive Test Implications
Sciatic nerve pathology
See Test
Babinski Test
Steps
Run metal edge of neurlogic hammer, or fingernail along the tplantar surface of the foot
from the calcaneus, along the lateral border of the foot to the forefoot
Positive Test
Great toe extension with flexion and splaying of the lateral four toes
Positive Test Implications
Upper motor neuron lesion
See Test
Slump Test
Steps
Subjects sits at end of table and leans forward while the examiner holds the head and chin
upright
Examiner then flexes the subjects neck and assesses for any changes in symptoms
If no changes are noted the examiner passively extends one of the subjects knees
Again, note symptomatic changes
If no changes are noted, the examiner passively dorsiflexes the subjects ankle while the
knee remains extended
Subject is then returned to original position and the test is repeated for the opposite leg
Positive Test
A complaint of sciatic–type pain or any reproduction of symptoms is indicative of a
positive test
Positive Test Implications
Sciatica or dural irritation
See Test
Single Straight Leg Raise Test
Steps
Subject begins supine with both knees extended
Examiner stands at subject’s side with distal hand cupping heel and proximal hand
around subjects thigh (anteriorly) to maintain knee extension
With subject relaxed the examiner slowly raises the test leg until tightness is noted
The examiner slowly lowers the leg until the pain or tightness resolves, then dorsiflexes
the ankle and instructs the subject to flex the neck
Positive Test & Implications
Leg and/or low back pain occurring with dorsiflexion and/or neck flexion indicates dural
involvement
A lack of pain reproduction with dorsiflexion and/or neck flexion indicates either
hamstring tightness, possible lumbar spine or sacroiliac involvement
If latter is determined, proceed to the bilateral straight leg raise test
See Test
Kernig Test
Steps
Subject supine with hands cupped behind head
Subject is instructed to flex cervical spine by lifting head
Each hip is unilaterally flexed to no more than 90, with knee fully extended
The opposite leg should remain on the table
Positive Test
Increased pain with both hip and neck flexion and pain is relieved when knee is allowed
to flex
Positive Test Implications
Meningeal irritation, nerve root impingement, dural irritation aggravated by spinal cord
elongation
See Test
Stork Test
Steps
Subject begins standing and is asked to extend back, while the examiner spots subject
The subject is then asked to stand on one foot and extend their back once again
Finally the subject is asked to stand on the opposite foot and extend the back
Positive Test
Complaints of pain in the lumbar region
Positive Test Implications
Possible pars intrarticularis pathology
Hoover Test
Steps
Subject is supine while examiner cups both heels of the patient with their hands
Subject is asked to perform a unilateral straight leg raise
Positive Test
1) Inability to raise leg
2) A positive finding is also noted when the examiner does not feel pressure in the palm
of the hand underlying the restimg leg
Positive Test Implications
1) neuromuscular weakness
2) lack of effort by subject