Waddell Sign: Difference between revisions

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== Technique<br>  ==
== Technique<br>  ==


1. Non-anatomical, widespread, referring tenderness in response to light touch.
#Non-anatomical, widespread, referring tenderness in response to light touch. Simulation tests<br>Axial loading of the spine applying light pressure through the head<br>With the patient in standing, passive hip and shoulder rotation  
 
#Distraction test - test a positive finding on a distracted patient<br>example: If pain is found in testing hip flexion, observe the patient in tying his shoes  
2. Simulation tests  
#Regional&nbsp;disturbances – experiencing sensory or motor disturbances that are lacking in neurologic basis  
 
#Overreaction during examination (tension, grimacing, verbalization, tremors, etc.)<ref name="Waddell">Waddell, G., McCulloch, J.A., Kummel, E., Venner, R.M. (1980). Nonorganic Physical Signs in Low-Back Pain. Spine, 5(2), 117-125.</ref>
&nbsp;&nbsp; &nbsp;a. Axial loading of the spine applying light pressure through the head  
 
&nbsp;&nbsp; &nbsp;b. With the patient in standing, passive hip and shoulder rotation  
 
3. Distraction test - test a positive finding on a distracted patient  
 
&nbsp;&nbsp; &nbsp;example: If pain is found in testing hip flexion, observe the patient in tying his shoes  
 
4. Regional&nbsp;disturbances – experiencing sensory or motor disturbances that are lacking in neurologic basis<br>5. Overreaction during examination (tension, grimacing, verbalization, tremors, etc.)<ref name="Waddell">Waddell, G., McCulloch, J.A., Kummel, E., Venner, R.M. (1980). Nonorganic Physical Signs in Low-Back Pain. Spine, 5(2), 117-125.</ref>  


== Evidence  ==
== Evidence  ==

Revision as of 22:28, 4 June 2009

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Purpose
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Waddell's signs were developed to identify psychogenic, or nonorganic, manifestations of pain in patients that may have heightened emotional effects on their conditions. In order for these signs to be significantly correlated with disability, three of the five signs should be present.[1]

Technique
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  1. Non-anatomical, widespread, referring tenderness in response to light touch. Simulation tests
    Axial loading of the spine applying light pressure through the head
    With the patient in standing, passive hip and shoulder rotation
  2. Distraction test - test a positive finding on a distracted patient
    example: If pain is found in testing hip flexion, observe the patient in tying his shoes
  3. Regional disturbances – experiencing sensory or motor disturbances that are lacking in neurologic basis
  4. Overreaction during examination (tension, grimacing, verbalization, tremors, etc.)[2]

Evidence[edit | edit source]

Provide the evidence for this technique here

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

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References[edit | edit source]

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  1. Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc
  2. Waddell, G., McCulloch, J.A., Kummel, E., Venner, R.M. (1980). Nonorganic Physical Signs in Low-Back Pain. Spine, 5(2), 117-125.