Prone Instability Test: Difference between revisions
Valerie Ross (talk | contribs) No edit summary |
No edit summary |
||
| Line 1: | Line 1: | ||
<br> | <br> | ||
== Purpose<sup>2</sup><br> == | == Purpose<sup>2</sup><br> == | ||
To test for the likelihood of a patient with low back pain responding to a stabilization exercise program. <br> | To test for the likelihood of a patient with low back pain responding to a stabilization exercise program. <br> | ||
<br> | <br> | ||
== Technique<sup>1</sup><sup>,2</sup><br> == | == Technique<sup>1</sup><sup>,2</sup><br> == | ||
The patient lies prone with the body on the examining table and legs over the edge and feet resting on the floor. While the patient rests in this position with the trunk muscles relaxed, the examiner applies posterior to anterior pressure to an individual spinous process of the lumbar spine. Any provocation of pain is reported. Then the patient lifts the legs off the floor (the patient may hold table to maintain position) and posterior to anterior compression is applied again to the lumbar spine while the trunk musculature is contracted. | The patient lies prone with the body on the examining table and legs over the edge and feet resting on the floor. While the patient rests in this position with the trunk muscles relaxed, the examiner applies posterior to anterior pressure to an individual spinous process of the lumbar spine. Any provocation of pain is reported. Then the patient lifts the legs off the floor (the patient may hold table to maintain position) and posterior to anterior compression is applied again to the lumbar spine while the trunk musculature is contracted. | ||
| Line 13: | Line 13: | ||
<br>The test is considered positive if pain is present in the resting position but subsides in the second position, suggesting lumbo-pelvic instability. The muscle activation is capable of stabilizing the spinal segment. | <br>The test is considered positive if pain is present in the resting position but subsides in the second position, suggesting lumbo-pelvic instability. The muscle activation is capable of stabilizing the spinal segment. | ||
<br> | <br> | ||
[[Image:DSC01195.JPG|left|300px|Test Position 1]]<br> | [[Image:DSC01195.JPG|left|300px|Test Position 1]]<br> | ||
<br> | <br> | ||
<br> | <br> | ||
<br> | <br> | ||
<br> | <br> | ||
<br> | <br> | ||
<br> | <br> | ||
<br> | <br> | ||
<br> | <br> | ||
<br> | <br> | ||
<br> | <br> | ||
[[Image:DSC01197.JPG|center|300px|Test Position 2]] | [[Image:DSC01197.JPG|center|300px|Test Position 2]] | ||
== Evidence<sup> | == Evidence<sup>3</sup> == | ||
Reference standard success with stabilization exercise program. | Reference standard success with stabilization exercise program. | ||
| Line 47: | Line 47: | ||
Specificity = .58 + LR = 1.7 | Specificity = .58 + LR = 1.7 | ||
<br> | <br> | ||
== Resources == | == Resources == | ||
| Line 53: | Line 53: | ||
[http://www.udel.edu/PT/manal/spinecourse/Instability/hicksfritzinstability.pdf Interrater Reliability of Clinical Examination Measures for Identification of Lumbar Segmental Instability] | [http://www.udel.edu/PT/manal/spinecourse/Instability/hicksfritzinstability.pdf Interrater Reliability of Clinical Examination Measures for Identification of Lumbar Segmental Instability] | ||
[http://www.ncbi.nlm.nih.gov/pubmed/18722203?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum Spinal palpation for lumbar segmental mobility and pain provocation: an interexaminer reliability study.]<br> | [http://www.ncbi.nlm.nih.gov/pubmed/18722203?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum Spinal palpation for lumbar segmental mobility and pain provocation: an interexaminer reliability study.]<br> | ||
<br> | <br> | ||
== References<br> == | == References<br> == | ||
1. Dutton, M. Orthopaedic Examination, Evaluation, and Intervention. New York: The McGraw-Hill Companies, Inc.; 2008.<br> | 1. Dutton, M. Orthopaedic Examination, Evaluation, and Intervention. New York: The McGraw-Hill Companies, Inc.; 2008.<br> | ||
2. Flynn T, Cleland J, Whitman J. User's Guide to the Musculoskeletal Examination: Fundamentals for the Evidence-based Clinician. Buckner, Kentucky: Evidence in Motion; 2008.<br> | 2. Flynn T, Cleland J, Whitman J. User's Guide to the Musculoskeletal Examination: Fundamentals for the Evidence-based Clinician. Buckner, Kentucky: Evidence in Motion; 2008.<br> | ||
3. Hicks G, FritzJ, 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. | |||
Revision as of 19:38, 4 June 2009
Purpose2
[edit | edit source]
To test for the likelihood of a patient with low back pain responding to a stabilization exercise program.
Technique1,2
[edit | edit source]
The patient lies prone with the body on the examining table and legs over the edge and feet resting on the floor. While the patient rests in this position with the trunk muscles relaxed, the examiner applies posterior to anterior pressure to an individual spinous process of the lumbar spine. Any provocation of pain is reported. Then the patient lifts the legs off the floor (the patient may hold table to maintain position) and posterior to anterior compression is applied again to the lumbar spine while the trunk musculature is contracted.
The test is considered positive if pain is present in the resting position but subsides in the second position, suggesting lumbo-pelvic instability. The muscle activation is capable of stabilizing the spinal segment.
Evidence3[edit | edit source]
Reference standard success with stabilization exercise program.
Sensitivity = .72 - LR = .48
Specificity = .58 + LR = 1.7
Resources[edit | edit source]
References
[edit | edit source]
1. Dutton, M. Orthopaedic Examination, Evaluation, and Intervention. New York: The McGraw-Hill Companies, Inc.; 2008.
2. Flynn T, Cleland J, Whitman J. User's Guide to the Musculoskeletal Examination: Fundamentals for the Evidence-based Clinician. Buckner, Kentucky: Evidence in Motion; 2008.
3. Hicks G, FritzJ, 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.
