Tech 1.4

  1. A listing is an abbreviated description for describing abnormal joint position or movement.

  2. All listings are described with the relationship of the superior vertebra compared with the inferior vertebra.

  3. Listing Conversions:

    • a. At T5, a right rotation restriction (RRR) is detected with palpatory tenderness. The National Diversified listing is LP (Left Posterior).

    • b. At T5, a right rotation restriction (RRR) is detected with palpatory tenderness. The Palmer Gonstead listing is PL (Posterior-Left).

    • c. At L3, a right rotation restriction and left lateral flexion restriction (LLFR) is detected with palpatory tenderness. The National Diversified listing is LPS.

    • d. At L3, a right rotation restriction and left lateral flexion restriction is detected with palpatory tenderness. The Palmer Gonstead listing is PRI.

  4. Does subluxation always cause pain? No. The Vertebral Subluxation Complex (VSC) cannot be confirmed or excluded based solely on pain; joint dysfunction may be asymptomatic.

  5. Does joint pain indicate joint hypomobility, hypermobility, or clinical instability? It can indicate all three.

  6. What are two characteristics of mechanical joint pain?

    1. It usually has pain-free intervals.

    2. It is aggravated by joint movement or activities of daily living (ADLs).

  7. After taking a patient history, examination of any complaint begins with superficial observation (abrasions, scars, posture, gait, etc.).

  8. Postural assessment has demonstrated reliability & validity as a screening procedure for distinguishing back pain subjects from normal ones.

  9. Describe the process of performing a postural evaluation: Instruct a standing patient to assume a relaxed stance (looking straight ahead, feet approximately 4-6 inches apart, arms at sides).

  10. What method of measuring gross range of motion has demonstrated consistent reproducibility within & between examiners? Inclinometry.

  11. Interexaminer reliability for segmental ROM palpation & end feel (EP) is generally varied.

  12. Intraexaminer reliability for EP motion palpation is higher than interexaminer reliability (though still categorized as varied).

  13. Inter & intraexaminer reliability for joint pain provocation tests is good.

  14. Inter & intraexaminer reliability for palpation of bony or soft tissue pain is good.

  15. Inter & intraexaminer reliability for palpation for soft tissue textural changes is low/varied.

  16. Inter & intraexaminer reliability for leg length evaluation is good for the prone, extended knee position and questionable in the prone flexed knee position.

  17. Joint play is evaluated with the joint in a neutral (or loose-packed) position.

  18. End play is evaluated as a joint nears its end range of motion (passive).

  19. The extra motion that is possible in a joint after cavitation is known as the paraphysiological space.

  20. Restriction of a joint in AROM is usually a result of muscular contraction or spasm.

  21. Restriction of a joint at the end range of passive motion is usually a result of shortening in the joint capsule or periarticular ligaments.

  22. Capsular end play, such as in the facet joints of the spine, should feel firm yet springy.

  23. Loss of normal end play resistance could indicate hypermobility or clinical instability.

  24. What are the limitations of radiographic marking systems? They often have low reliability, poor clinical correlation to symptoms, and involve unnecessary patient exposure to radiation.

  25. Currently in the literature, there is insufficient justification for the routine use of radiographic spinal displacement analysis in clinical practice.

  26. Algometry has demonstrated good reliability & responsiveness, and can be used as a measureable outcome.