Orthopedic Assessment Tests For Lumbopelvic Conditions

1. You would like to assess the strength of your client's hip abductors, specifically his/her gluteus medius.

FABER Test (Patrick's Test)

Trendelenburg's Test

Lateral Pelvic Tilt Test

Pace Abduction Test

The Trendelenburg's Test is used to assess the strength of the hip abductors, particularly the gluteus medius muscle. During this test, the client stands on one leg while the examiner observes for any dropping or tilting of the opposite side of the pelvis. If the pelvis drops on the unsupported side, it indicates weakness of the hip abductors, specifically the gluteus medius. This test helps to identify any muscle imbalances or weaknesses that may contribute to hip instability or gait abnormalities.

Explanation

The Trendelenburg's Test is used to assess the strength of the hip abductors, particularly the gluteus medius muscle. During this test, the client stands on one leg while the examiner observes for any dropping or tilting of the opposite side of the pelvis. If the pelvis drops on the unsupported side, it indicates weakness of the hip abductors, specifically the gluteus medius. This test helps to identify any muscle imbalances or weaknesses that may contribute to hip instability or gait abnormalities.

2. What does a positive Modified Thomas Test indicate?

Lateral pelvic tilt

Hypertonic iliopsoas and/or rectus femoris

Piriformis syndrome

Hypotonic gluteus medius

A positive Modified Thomas Test indicates hypertonic iliopsoas and/or rectus femoris. The Modified Thomas Test is a physical examination technique used to assess hip flexor tightness. If the test is positive, it means that the hip flexor muscles, specifically the iliopsoas and/or rectus femoris, are tight and shortened. This can lead to various issues such as decreased hip mobility, altered posture, and potential compensatory movement patterns.

Explanation

A positive Modified Thomas Test indicates hypertonic iliopsoas and/or rectus femoris. The Modified Thomas Test is a physical examination technique used to assess hip flexor tightness. If the test is positive, it means that the hip flexor muscles, specifically the iliopsoas and/or rectus femoris, are tight and shortened. This can lead to various issues such as decreased hip mobility, altered posture, and potential compensatory movement patterns.

3. If a client reports pain during a Straight Leg Raise Test while the leg is raised 30-60 degrees from the table, what is the likely source of the pain?

SI joint pathology

Hypertonic hip extensors

Sciatic nerve involvement

Osteoarthritis of the hip

The likely source of the pain during a Straight Leg Raise Test when the leg is raised 30-60 degrees from the table is sciatic nerve involvement. The Straight Leg Raise Test is used to assess for sciatic nerve irritation or compression. If the client experiences pain during this test, it suggests that the sciatic nerve is being affected, possibly due to compression or inflammation. This can occur in conditions such as a herniated disc, piriformis syndrome, or spinal stenosis.

Explanation

The likely source of the pain during a Straight Leg Raise Test when the leg is raised 30-60 degrees from the table is sciatic nerve involvement. The Straight Leg Raise Test is used to assess for sciatic nerve irritation or compression. If the client experiences pain during this test, it suggests that the sciatic nerve is being affected, possibly due to compression or inflammation. This can occur in conditions such as a herniated disc, piriformis syndrome, or spinal stenosis.

4. Which of the following assessment tests would you use to determine the presence of a contracted TFL and/or ITB?

Straight Leg Raise Test

Bowstring Test

Modified Thomas Test

Ober's Test

Ober's Test is used to assess the tightness or contracture of the tensor fasciae latae (TFL) and iliotibial band (ITB). During this test, the patient lies on their side with the lower leg flexed at the hip and knee. The therapist then abducts and extends the upper leg, allowing it to hang freely. If the leg remains above the horizontal plane, it indicates a contracted TFL and/or ITB. This test helps in diagnosing conditions such as iliotibial band syndrome and can guide the appropriate treatment plan.

Explanation

Ober's Test is used to assess the tightness or contracture of the tensor fasciae latae (TFL) and iliotibial band (ITB). During this test, the patient lies on their side with the lower leg flexed at the hip and knee. The therapist then abducts and extends the upper leg, allowing it to hang freely. If the leg remains above the horizontal plane, it indicates a contracted TFL and/or ITB. This test helps in diagnosing conditions such as iliotibial band syndrome and can guide the appropriate treatment plan.

5. What specific action performed during the Piriformis Test (which assesses the extent of piriformis syndrome) will produce the pain indicative of a positive test?

Having the client lie on his/her unaffected side

Passively bringing the hip into 60 degrees flexion

Adducting the flexed hip

Flexing the knee

Obviously, someone with a severely compressed sciatic nerve will likely feel pain with the hip simply flexed, before adduction is performed.

Explanation

Obviously, someone with a severely compressed sciatic nerve will likely feel pain with the hip simply flexed, before adduction is performed.

6. You suspect that your client may have some sacroiliac joint dysfunction. What test would NOT be used to confirm this suspicion?

FABER Test (Patrick's Test)

Gaenslen's Test

Thigh Thrust Test

Nobel's Test

Nobel's Test is not used to confirm the suspicion of sacroiliac joint dysfunction. The FABER Test (Patrick's Test), Gaenslen's Test, and Thigh Thrust Test are commonly used to assess the sacroiliac joint and can help confirm the suspicion of dysfunction. However, Nobel's Test is not specifically designed to assess the sacroiliac joint and is not commonly used for this purpose.

Explanation

Nobel's Test is not used to confirm the suspicion of sacroiliac joint dysfunction. The FABER Test (Patrick's Test), Gaenslen's Test, and Thigh Thrust Test are commonly used to assess the sacroiliac joint and can help confirm the suspicion of dysfunction. However, Nobel's Test is not specifically designed to assess the sacroiliac joint and is not commonly used for this purpose.

7. This postural distortion may be caused by (or cause) either exaggerated lumbar lordosis or reduced lumbar lordosis. Which test would you use to assess the extent of this distortion?

Lateral Pelvic Tilt Test

Renne's Test

Anterior and Posterior Innominate Rotation Test

Bowstring Test

The postural disorder is (obviously) anterior or posterior innominate/pelvic rotation

Explanation

The postural disorder is (obviously) anterior or posterior innominate/pelvic rotation

8. With your client supine, you flex his/her hip and knee and, stabilizing the opposite hip with your hand, gently push the flexed knee away from yourself. You ask the client if the action increses his/her low back pain. You are performing the:

FADIR Test

Thigh Thrust Test

Renne's Test

FABER Test (Patrick's Test)

The FADIR test is performed by flexing the client's hip and knee, while stabilizing the opposite hip with your hand, and gently pushing the flexed knee away from yourself. This test is used to assess for hip joint pathology, specifically for impingement or labral tears. By reproducing the client's low back pain during this test, it suggests that there may be hip joint involvement contributing to their symptoms.

Explanation

The FADIR test is performed by flexing the client's hip and knee, while stabilizing the opposite hip with your hand, and gently pushing the flexed knee away from yourself. This test is used to assess for hip joint pathology, specifically for impingement or labral tears. By reproducing the client's low back pain during this test, it suggests that there may be hip joint involvement contributing to their symptoms.