Lumbopelvic Competency

5-7 cm

what is the normal range for lumbar flexion using a tape measure?

1-3 cm

what is the normal range for lumbar extension using a tape measure?

18-38

what is the normal range for thoracolumbar sidebending?

lumbar flexion

15 cm above S2

lumbar extension

15 cm above S2

thoracolumbar SB

S2 and inline with C7

lumbar flexion overpressure

lumbar extension overpressure

lateral flexion overpressure

mckenzie lateral shift correction

pull pelvis towards you and hold 10-15 seconds

+ if increased symptoms on affected side

if pt has a lateral shift deformity, an opposite side glide will help determine if it is correctable

flexion PPIVM

SP should gap with flexion

extension PPIVM

SPs should compress with extension

sidebending PPIVM

R sidelying: SP should gap on the R and compress on the L

L sidelying: SP should gap on the L and compress on the R

L2 dermatome

anterior mid-thigh

L3 dermatome

medial side of the knee joint

L4 dermatome

medial lower leg and foot

L5 dermatome

anterolateral leg to the dorsum of the foot

S1 dermatome

lateral side of the foot

S2 dermatome

mid posterior thigh and calf and plantar surface of the foot

L2 myotome

resisted hip flexion

L3 myotome

resisted knee extension

L4 myotome

resisted DF and inversion

L5 myotome

resisted great toe extension

S1 myotome

resisted ankle PF and eversion

prone instability test

+ test if pain is present in first part, but subsides in second part

part of CPR for lumbar instability

stork standing test

(+) for pars interarticularis defect on loaded side

palpate both PSIS

slump test

identifies dysfunction of neurological structures supplying the lower limb

+ if symptoms earlier in motion and asymmetrical

sacral thrust test

6 vigorous downward thrusts at S2-S3

+ if concordant sign is produced

flexion in standing test

palpate both PSIS

+ test if asymmetry of motion of one PSIS relative to the other

testing for motion restriction

gillet's test

palpate both PSIS or PSIS and S2

should have inferior and lateral movement of tested PSIS relative to the sacrum

+ test if no inferior movement or PSIS moves anterior of thumb on PSIS

alternate gillet test

patient standing with equal weight through each leg

- therapist palpates the innominate bone, PSIS, and sacrum by placing the R thumb directly on R PSIS with the rest of the R hand contacting the R innominate bone

- palpate S2 with L thumb

- patient actively flexes the CL hip into 90 degrees of flexion and 90 knee flexion

- + test if R PSIS moves upward

- (-) test if unchanged

supine to long sit test

therapist passively flexes both legs and then extends them

- compare positions of the malleoli in supine and then compare when patient comes into sitting

anterior

if a patient's leg moves from long to short the innominate is _____

posterior

if a patient's leg moves from short to long the innominate is _____

SIJ compression

compresses posteriorly and distracts anteriorly

+ if concordant pain is reproduced

SIJ distraction

compresses anteriorly and gaps posteriorly

+ if concordant pain is reproduced

active SLR

+ test: when the patient is able to lift the leg higher and/or has

decreased symptoms with the leg lift when PT compresses SIJ

POSH test

hand under sacrum and push posteriorly through the femur at varying angles of abd/add

+ if buttock pain is reproduced

thomas test

tests muscle length of iliopsoas/rectus femoris

hip rotation in prone test

test IR and ER

assess for symmetry

sorensen test

tests the endurance of back extensors

> 28 seconds

what is the norm for men for the sorensen test?

> 29 seconds

what is the norm for women for the Sorensen test?

double leg lowering test

measures core stability and strength

0-15 degrees

5 for double leg lowering?

15-45 degrees

4 for double leg lowering

45-75 degrees

3 for double leg lowering

75-90 degrees

2 for double leg lowering

unable to hold pelvis in neutral

1 for double leg lowering

spine rotators and multifidi test

1. single straight arm hold

2. single straight leg hold

3. CL straight arm and leg hold

assesses ability of the spinal rotators and multifidus to stabilize the trunk during dynamic extremity movements

CL arm and leg lift 20-30s

grade 5 for spine rotators/multifidus

single leg lift 15-20s

grade 4 for spine rotators/multifidus

single arm lift 15-20s

grade 3 for spine rotators/multifidus

unable to hold during staight arm raise

grade 2 for spine rotators/multifidus

unable to raise arm or leg

grade 1 for spine rotators/multifidus

supine isometric chest raise test

34 seconds

what is the norm for men for the supine isometric chest raise test?

24 seconds

what is the norm for women for the isometric chest raise test?

sacral sulci palpation

assess for depth, tenderness, and swelling

look for one side deeper and one side more shallow

ILA palpation

-Sacral Sulci

-Thumbs walk down until you fall off sacrum

sacrotuberous ligament palpation

runs from the ischial tuberosity to the sacrum. So you will find the distal aspect of the sacrum and the ischial tuberosity and the line formed between both these points will be the ligament. You can run your finger perpendicular to confirm the structure.

lumbar central PA

1. Stand over pt with long lever arm (vertical, arm over palm), stand in a straddle & hinge at hips; Extend wrist to tension/lock pisiform

3. Palpate spinous process with pisiform & assess for resistance/symmetry/pain/asymmetry

lumbar unilateral PA

Palpate transverse process with pisiform or thumb; TP is almost directly across from SP

- Causes contralateral rotation: Compression of superior contralateral side, distraction of superior ipsilateral side; Opposite occurs at the inferior facets

lumbar transverse PAIVM