Slump Test: Difference between revisions

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The Slump Test is a neural tension test used to detect altered neurodynamics or neural tissue sensitivity.<ref>Flynn TW, Cleland JA, Whitman JM. Users' Guide to the Musculoskeletal Examination: Fundamentals for the Evidence-Based Clinician. Buckner: Evidence in Motion; 2008.</ref><br>  
The Slump Test is a neural tension test used to detect altered neurodynamics or neural tissue sensitivity.<ref>Flynn TW, Cleland JA, Whitman JM. Users' Guide to the Musculoskeletal Examination: Fundamentals for the Evidence-Based Clinician. Buckner: Evidence in Motion; 2008.</ref><br>  


== Technique<ref>Dutton M. Orthopaedic Examination, Evaluation and Intervention. 2nd ed. New York: McGraw-Hill Companies, Inc.; 2008.</ref><br> ==
== Technique<ref>Dutton M. Orthopaedic Examination, Evaluation and Intervention. 2nd ed. New York: McGraw-Hill Companies, Inc.; 2008.</ref><br> ==


A positive sign for the Slump Test is reproduction of pain that is unrelieved by a change in tension of the dura.
'''Note:'''


To begin the test, have the patient seated with hands behind back to achieve a neutral spine. The first step is to have the patient slump forward at the thoracic and lumbar spine. If this position is negative,&nbsp;have the patient flex the neck by placing the chin on the chest and then extending&nbsp;one knee as much as possible.  
The slump test is described differently among sources.&nbsp;The common factor of factor among sources is the&nbsp;reproduction&nbsp;of pain as tension is&nbsp;applied to the dura during the test.&nbsp;The technique depicted below is&nbsp;adapted from&nbsp;Mark Dutton.  


If&nbsp;this position causes pain, have the patient extend the neck into neutral. If the patient is still unable to extend the&nbsp;knee due to pain, the&nbsp;test is considered positive.&nbsp;  
'''Description:'''
 
To begin the test, have the patient seated with hands behind back to achieve a neutral spine. The first step is to have the patient slump forward at the thoracic and lumbar spine. If this position does not cause pain,&nbsp;have the patient flex the neck by placing the chin on the chest and then extending&nbsp;one knee as much as possible.
 
If&nbsp;extending the knee causes pain, have the patient extend the neck into neutral. If the patient is still unable to extend the&nbsp;knee due to pain, the&nbsp;test is considered positive.&nbsp;  


If&nbsp;extending the knee&nbsp;does not cause pain, ask the patient to actively dorsiflex the ankle. If dorsiflexion causes pain, have the patient slightly flex the knee while still dorsiflexing. If the pain is reproduced, the test is considered positive.  
If&nbsp;extending the knee&nbsp;does not cause pain, ask the patient to actively dorsiflex the ankle. If dorsiflexion causes pain, have the patient slightly flex the knee while still dorsiflexing. If the pain is reproduced, the test is considered positive.  
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Overpressure can be applied during any of the test positions.  
Overpressure can be applied during any of the test positions.  


{{#ev:youtube|8Qknf8yyMFQ}}<ref>Online Video, http://www.youtube.com/watch?v=8Qknf8yyMFQ</ref>  
{{#ev:youtube|8Qknf8yyMFQ}}<ref>Online Video, http://www.youtube.com/watch?v=8Qknf8yyMFQ</ref>


== Evidence  ==
== Evidence  ==

Revision as of 16:37, 5 June 2009

Original Editor - Whitney Bass and Kim Bevillard

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Purpose
[edit | edit source]

The Slump Test is a neural tension test used to detect altered neurodynamics or neural tissue sensitivity.[1]

Technique[2]
[edit | edit source]

Note:

The slump test is described differently among sources. The common factor of factor among sources is the reproduction of pain as tension is applied to the dura during the test. The technique depicted below is adapted from Mark Dutton.

Description:

To begin the test, have the patient seated with hands behind back to achieve a neutral spine. The first step is to have the patient slump forward at the thoracic and lumbar spine. If this position does not cause pain, have the patient flex the neck by placing the chin on the chest and then extending one knee as much as possible.

If extending the knee causes pain, have the patient extend the neck into neutral. If the patient is still unable to extend the knee due to pain, the test is considered positive. 

If extending the knee does not cause pain, ask the patient to actively dorsiflex the ankle. If dorsiflexion causes pain, have the patient slightly flex the knee while still dorsiflexing. If the pain is reproduced, the test is considered positive.

Repeat test on opposite side.

Overpressure can be applied during any of the test positions.

[3]

Evidence[edit | edit source]

In patients with lumbar disc herniations, sensitivity was found to be 0.84 and specificity 0.83.[4]

Resources[edit | edit source]

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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  1. Flynn TW, Cleland JA, Whitman JM. Users' Guide to the Musculoskeletal Examination: Fundamentals for the Evidence-Based Clinician. Buckner: Evidence in Motion; 2008.
  2. Dutton M. Orthopaedic Examination, Evaluation and Intervention. 2nd ed. New York: McGraw-Hill Companies, Inc.; 2008.
  3. Online Video, http://www.youtube.com/watch?v=8Qknf8yyMFQ
  4. Majlesi J, Togay H, Unalan H, Toprak S. The sensitivity and specificity of the Slump and the Straight Leg Raising tests in patients with lumbar disc herniation. J Clin Rheumatol. Apr 2008;14(2):87-91.