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TSPT Cervical Spine CourseMany physical therapists are hesitant to perform a cervical spine evaluation due to a lack of confidence. This course is designed to enhance the participant's knowledge and understanding of the cervical spine to become a more efficient, effective, and knowledgeable practitioner of cervical pathologies!
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Spurling's Maneuver
Purpose: To assess the contributions of cervical radiculopathy to the patient’s pain.
Test Position: Sitting.
Performing the Test: Laterally flex the head to the unaffected side. Apply an axial compression force through the top of the head. Repeat on affected side. Reproduction of pain may signal cervical radiculopathy, especially when combined with other tests. Note that the test is not lateral flexion overpressure; it is an axial compression in the laterally flexed position.
Diagnostic Accuracy: Specificity: .50; Sensitivity: .88; -LR: .58; +LR: 3.5 (“Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy”).
Importance of the Test: As disc height decreases and bone spurs accumulate, the space for nerves to enter and exit the vertebral canal gets smaller. Certain neck positions close that gap and put even more pressure on the nerves. This test tries to recreate those sensitive positions by compressing the vertebrae, thus, pressing down on the nerve roots or other innervated structures, if compromised. It should be noted that the diagnostic accuracy of tests for cervical radiculopathy improve when clustered with other exam measures (check out the cervical homepage!).
Note: tests should only be performed by a properly trained health care practitioner.
Test Position: Sitting.
Performing the Test: Laterally flex the head to the unaffected side. Apply an axial compression force through the top of the head. Repeat on affected side. Reproduction of pain may signal cervical radiculopathy, especially when combined with other tests. Note that the test is not lateral flexion overpressure; it is an axial compression in the laterally flexed position.
Diagnostic Accuracy: Specificity: .50; Sensitivity: .88; -LR: .58; +LR: 3.5 (“Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy”).
Importance of the Test: As disc height decreases and bone spurs accumulate, the space for nerves to enter and exit the vertebral canal gets smaller. Certain neck positions close that gap and put even more pressure on the nerves. This test tries to recreate those sensitive positions by compressing the vertebrae, thus, pressing down on the nerve roots or other innervated structures, if compromised. It should be noted that the diagnostic accuracy of tests for cervical radiculopathy improve when clustered with other exam measures (check out the cervical homepage!).
Note: tests should only be performed by a properly trained health care practitioner.
References:
Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. "Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy." Spine (Phila Pa 1976) 2003 Jan 1. Web. 08/18/2012.
Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. "Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy." Spine (Phila Pa 1976) 2003 Jan 1. Web. 08/18/2012.