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    • Special Tests >
      • Cervical Spine >
        • Alar Ligament Test
        • Bakody's Sign
        • Cervical Distraction Test
        • Cervical Rotation Lateral Flexion Test
        • Craniocervical Flexion Test (CCFT)
        • Deep Neck Flexor Endurance Test
        • Posterior-Anterior Segmental Mobility
        • Segmental Mobility
        • Sharp-Purser Test
        • Spurling's Maneuver
        • Transverse Ligament Test
        • ULNT - Median
        • ULNT - Radial
        • ULNT - Ulnar
        • Vertebral Artery Test
      • Thoracic Spine >
        • Adam's Forward Bend Test
        • Passive Neck Flexion Test
        • Thoracic Compression Test
        • Thoracic Distraction Test
        • Thoracic Foraminal Closure Test
      • Lumbar Spine/Sacroiliac Joint >
        • Active Sit-Up Test
        • Alternate Gillet Test
        • Crossed Straight Leg Raise Test
        • Extensor Endurance Test
        • FABER Test
        • Fortin's Sign
        • Gaenslen Test
        • Gillet Test
        • Gower's Sign
        • Lumbar Quadrant Test
        • POSH Test
        • Posteroanterior Mobility
        • Prone Knee Bend Test
        • Prone Instability Test
        • Resisted Abduction Test
        • Sacral Clearing Test
        • Seated Forward Flexion Test
        • SIJ Compression/Distraction Test
        • Slump Test
        • Sphinx Test
        • Spine Rotators & Multifidus Test
        • Squish Test
        • Standing Forward Flexion Test
        • Straight Leg Raise Test
        • Supine to Long Sit Test
      • Shoulder >
        • Active Compression Test
        • Anterior Apprehension
        • Biceps Load Test II
        • Drop Arm Sign
        • External Rotation Lag Sign
        • Hawkins-Kennedy Impingement Sign
        • Horizontal Adduction Test
        • Internal Rotation Lag Sign
        • Jobe Test
        • Ludington's Test
        • Neer Test
        • Painful Arc Sign
        • Pronated Load Test
        • Resisted Supination External Rotation Test
        • Speed's Test
        • Posterior Apprehension
        • Sulcus Sign
        • Thoracic Outlet Tests >
          • Adson's Test
          • Costoclavicular Brace
          • Hyperabduction Test
          • Roos (EAST)
        • Yergason's Test
      • Elbow >
        • Biceps Squeeze Test
        • Chair Sign
        • Cozen's Test
        • Elbow Extension Test
        • Medial Epicondylalgia Test
        • Mill's Test
        • Moving Valgus Stress Test
        • Push-up Sign
        • Ulnar Nerve Compression Test
        • Valgus Stress Test
        • Varus Stress Test
      • Wrist/Hand >
        • Allen's Test
        • Carpal Compression Test
        • Finkelstein Test
        • Phalen's Test
        • Reverse Phalen's Test
      • Hip >
        • Craig's Test
        • Dial Test
        • FABER Test
        • FAIR Test
        • Fitzgerald's Test
        • Hip Quadrant Test
        • Hop Test
        • Labral Anterior Impingement Test
        • Labral Posterior Impingement Test
        • Long-Axis Femoral Distraction Test
        • Noble Compression Test
        • Percussion Test
        • Sign of the Buttock
        • Trendelenburg Test
      • Knee >
        • Anterior Drawer Test
        • Dial Test (Tibial Rotation Test)
        • Joint Line Tenderness
        • Lachman Test
        • McMurray Test
        • Noble Compression Test
        • Pivot-Shift Test
        • Posterior Drawer Test
        • Posterior Sag Sign
        • Quad Active Test
        • Thessaly Test
        • Valgus Stress Test
        • Varus Stress Test
      • Foot/Ankle >
        • Anterior Drawer
        • Calf Squeeze Test
        • External Rotation Test
        • Fracture Screening Tests
        • Impingement Sign
        • Navicular Drop Test
        • Squeeze Test
        • Talar Tilt
        • Tarsal Tunnel Syndrome Test
        • Test for Interdigital Neuroma
        • Windlass Test

NOW AVAILABLE!!!

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TSPT Lumbar Spine Course

For more information on how to manage the lumbosacral region, check out our new Lumbar Spine Course! With over 5 hours of lecture, videos on advance assessment/treatment techniques, articles to enhance your learning and more, you will feel more confident and competent with each patient with lumbar involvement. Learn from board-certified and residency trained therapists in order to improve your knowledge and skills.
Learn More!

Lumbar Spine/Sacraliliac Joint

Range of Motion

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ROM of Lumbar Spine:
Flexion: ~60 degrees (double inclinometer); 5-7 in (Modified-Schober)
Extension: ~35 degrees (double inclinometer); 1-3 in (Modified-Schober)
Lateral Flexion: 25-30 degrees (double inclinometer)
Thoracolumbar Lateral Flexion: assess distance from middle finger tip to floor (compare side-to-side) 
Rotation: not assessed to due difficulty differentiating from T-spine

Lumbar Clearing Test:
Lumbar Quadrant Test

Sacrailiac Clearing Test:
Sacral Clearing Test

(Due to the low diagnostic accuracy of this test, it is best to follow the cluster below for truly assessing the SI joint)

Manual Muscle Tests

Coming soon...

Special Tests

Active Sit-Up Test
Alternate Gillet Test
Crossed Straight Leg Raise Test
Extensor Endurance Test
FABER Test
Fortin's Sign
Gaenslen Test
Gillet Test
Gower's Sign
Lumbar Quadrant Test
POSH Test
Posteroanterior Mobility
Prone Knee Bend Test
Prone Instability Test
Resisted Abduction Test
Sacral Clearing Test
Seated Forward Flexion Test
SIJ Compression/Distraction Test
Slump Test
Sphinx Test
Spine Rotators & Multifidus Test
Squish Test
Standing Forward Flexion Test
Straight Leg Raise Test
Supine to Long Sit Test
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Lumbosacral Research

Cluster for Patients Likely to Benefit from Spinal Manipulation (Childs et al, 2004):
-Duration of current low back pain for less than or equal to 16 days
-No symptoms below the knee
-FABQ work subscale score 18 points or less
-Segmental mobility testing results in finding 1 or more hypomobile segments in the lumbar spine
-Hip internal rotation with at least one hip having at least 35 degrees of internal rotation

1-2 positive: -LR: .1
4-5 positive: +LR: 13.2

Cluster for Patients Likely to Benefit from Lumbar Stabilization Exercise Training (Hicks et al, 2005):
-Age<40
-Avg Straight Leg Raise > 91 degrees
-Positive Prone Instability Test
-Aberrant movement present (found during lumbar ROM test). Often described as instability catch, painful arc of motion, Gower's sign, or a reversal of lumbopelvic motion

1 positive: -LR: .2
2 positive: -LR: .3
3 or 4 positive: +LR: 4.0

Cluster for Patients with Low Back Pain Likely to Benefit from Mechanical Traction (Cai et al 2009 & Fritz et al 2007):
-FABQ-W score < 21
-No neurological deficit involvement
-Age>30
-Non-manual work job status

3 positive: Sn .76, Sp .75
4 positive: Sn .36, Sp .96


Cluster for Pain Originating from Sacroiliac Joint (Stuber 2007):
-Sacral Clearing Test
-SIJ Compression
-Distraction Test

-POSH Test
-Gaenslen's Test

1 positive: Sn 1.0, Sp .44
2 positive: Sn .93, Sp .66
3 positive: Sn .94, Sp .78
4 positive: Sn .6, Sp .81
5 positive: Sn .27, Sp .88


Cluster for S&S Indicative of Spinal Stenosis (Cook et al, 2011):
-Bilateral symptoms
-Leg pain > back pain
-Pain during walking/standing
-Pain relief upon sitting
->48 years old

1 positive: Sn .96, Sp .2, +LR 1.2, -LR .19
2 positive: Sn .68, Sp .62, +LR 1.8, -LR .51
3 positive: Sn .29, Sp .88, +LR 2.5, -LR .8
4 positive: Sn .06, Sp .98, +LR 4.6, -LR .95
5 positive: Sn .01, Sp 1.0, +LR infinite, -LR .99


Note: tests should only be performed by a properly trained health care practitioner.

References:
Broadhurst N, Bond M. "Pain provocation tests for the assessment of sacroiliac joint dysfunction." J Spinal Disorders 1998; 11: 341-345.

Cai C, et al. A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with mechanical lumbar traction. Eur Spine J. 2009; 18(4): 554-61.

Childs JD, Fritz JM, Flynn TW, et al. "A clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation: a validation study." Ann Intern Med 2004; 141: 920-928.

Cook C, Brown C, Michael K, Isaacs R, Howes C, Richardson W, Roman M, Hegedus E. The clinical value of a cluster of patient history and observational findings as a diagnostic support tool for lumbar spine stenosis. Physiother Res Int. 2011; 16(3):170-8.

Fritz JM, et al. Is there a subgroup of patients with low back pain likely to benefit from mechanical traction? Results of a randomized clinical trial and subgrouping analysis. Spine. 2007; 32(26): E793-800.

Hicks G, Fritz J, Delitto A, McGill S. "Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program." Arch Phys Med Rehabil 2005; 86: 1753-1762.

Laslett M, et al. Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Manual Therapy. 2005; 10(3): 207-18.

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Copyright © The Student Physical Therapist LLC 2022
  • Home
  • About Us
  • Insider Access
    • About Insider Access
  • Online Courses
    • Hooper's Knee
    • Physical Therapist Entrepreneur Course
    • Physical Therapist Consultant Course
    • Orthopedic Management of the Cervical Spine
    • Return to Sport Essentials Course
  • Resources
    • Newsletter
    • Business Minded Sports Physio Podcast
    • Day in the Life of a Sports PT
    • Residency Corner
    • Special Tests >
      • Cervical Spine >
        • Alar Ligament Test
        • Bakody's Sign
        • Cervical Distraction Test
        • Cervical Rotation Lateral Flexion Test
        • Craniocervical Flexion Test (CCFT)
        • Deep Neck Flexor Endurance Test
        • Posterior-Anterior Segmental Mobility
        • Segmental Mobility
        • Sharp-Purser Test
        • Spurling's Maneuver
        • Transverse Ligament Test
        • ULNT - Median
        • ULNT - Radial
        • ULNT - Ulnar
        • Vertebral Artery Test
      • Thoracic Spine >
        • Adam's Forward Bend Test
        • Passive Neck Flexion Test
        • Thoracic Compression Test
        • Thoracic Distraction Test
        • Thoracic Foraminal Closure Test
      • Lumbar Spine/Sacroiliac Joint >
        • Active Sit-Up Test
        • Alternate Gillet Test
        • Crossed Straight Leg Raise Test
        • Extensor Endurance Test
        • FABER Test
        • Fortin's Sign
        • Gaenslen Test
        • Gillet Test
        • Gower's Sign
        • Lumbar Quadrant Test
        • POSH Test
        • Posteroanterior Mobility
        • Prone Knee Bend Test
        • Prone Instability Test
        • Resisted Abduction Test
        • Sacral Clearing Test
        • Seated Forward Flexion Test
        • SIJ Compression/Distraction Test
        • Slump Test
        • Sphinx Test
        • Spine Rotators & Multifidus Test
        • Squish Test
        • Standing Forward Flexion Test
        • Straight Leg Raise Test
        • Supine to Long Sit Test
      • Shoulder >
        • Active Compression Test
        • Anterior Apprehension
        • Biceps Load Test II
        • Drop Arm Sign
        • External Rotation Lag Sign
        • Hawkins-Kennedy Impingement Sign
        • Horizontal Adduction Test
        • Internal Rotation Lag Sign
        • Jobe Test
        • Ludington's Test
        • Neer Test
        • Painful Arc Sign
        • Pronated Load Test
        • Resisted Supination External Rotation Test
        • Speed's Test
        • Posterior Apprehension
        • Sulcus Sign
        • Thoracic Outlet Tests >
          • Adson's Test
          • Costoclavicular Brace
          • Hyperabduction Test
          • Roos (EAST)
        • Yergason's Test
      • Elbow >
        • Biceps Squeeze Test
        • Chair Sign
        • Cozen's Test
        • Elbow Extension Test
        • Medial Epicondylalgia Test
        • Mill's Test
        • Moving Valgus Stress Test
        • Push-up Sign
        • Ulnar Nerve Compression Test
        • Valgus Stress Test
        • Varus Stress Test
      • Wrist/Hand >
        • Allen's Test
        • Carpal Compression Test
        • Finkelstein Test
        • Phalen's Test
        • Reverse Phalen's Test
      • Hip >
        • Craig's Test
        • Dial Test
        • FABER Test
        • FAIR Test
        • Fitzgerald's Test
        • Hip Quadrant Test
        • Hop Test
        • Labral Anterior Impingement Test
        • Labral Posterior Impingement Test
        • Long-Axis Femoral Distraction Test
        • Noble Compression Test
        • Percussion Test
        • Sign of the Buttock
        • Trendelenburg Test
      • Knee >
        • Anterior Drawer Test
        • Dial Test (Tibial Rotation Test)
        • Joint Line Tenderness
        • Lachman Test
        • McMurray Test
        • Noble Compression Test
        • Pivot-Shift Test
        • Posterior Drawer Test
        • Posterior Sag Sign
        • Quad Active Test
        • Thessaly Test
        • Valgus Stress Test
        • Varus Stress Test
      • Foot/Ankle >
        • Anterior Drawer
        • Calf Squeeze Test
        • External Rotation Test
        • Fracture Screening Tests
        • Impingement Sign
        • Navicular Drop Test
        • Squeeze Test
        • Talar Tilt
        • Tarsal Tunnel Syndrome Test
        • Test for Interdigital Neuroma
        • Windlass Test