Cervical Distraction Test: Difference between revisions
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To test for the presence of cervical radiculopathy.<ref name="Users' guide">Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. United States; Evidence in Motion:2008.</ref> <ref name="Malange et al">Malange GA,Landes P, Nadler SF. Provocation tests in the cervical spine examination: historical basis and scientific analyses. Pain Physician. 2003;6:199-205</ref><br> | To test for the presence of cervical radiculopathy.<ref name="Users' guide">Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. United States; Evidence in Motion:2008.</ref> <ref name="Malange et al">Malange GA,Landes P, Nadler SF. Provocation tests in the cervical spine examination: historical basis and scientific analyses. Pain Physician. 2003;6:199-205</ref><br> | ||
== Test Position == | == Test Position == | ||
Supine | |||
== Technique<br> == | == Technique<br> == | ||
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Patient lies supine and the neck is comfortably positioned. Examiner securely grasps the patient's either by placing each hand around the patient’s mastoid processes, while standing at their head, or place one hand on their forehead and the other on the occiput. Slightly flex the patient’s neck and pull the head towards your torso, applying a distraction force <ref name="Wainner and Gill" /> <ref name=" | Patient lies supine and the neck is comfortably positioned. Examiner securely grasps the patient's either by placing each hand around the patient’s mastoid processes, while standing at their head, or place one hand on their forehead and the other on the occiput. Slightly flex the patient’s neck and pull the head towards your torso, applying a distraction force <ref name="Wainner and Gill" /> <ref name="Wainner et al" /> | ||
A positive test is the reduction or elimination of symptoms with traction .<ref name="Wainner and Gill">Wainner RS, Gill H. Diagnosis and nonoperative management of cervical radiculopathy. J Ortho Sports PT.2000 Dec;30(12):728-744.</ref> <ref name=" | A positive test is the reduction or elimination of symptoms with traction .<ref name="Wainner and Gill">Wainner RS, Gill H. Diagnosis and nonoperative management of cervical radiculopathy. J Ortho Sports PT.2000 Dec;30(12):728-744.</ref> <ref name="Wainner et al">http://www.thestudentphysicaltherapist.com/cervical-distraction-test.html</ref><br> | ||
== Importance of Test == | == Importance of Test == | ||
As disc height decreases and bone spurs accumulate, the space for nerves to enter and exit the vertebral canal gets smaller. The decreased space can result in greater pressure on the nerve roots or other innervated structures, causing pain and weakness. With distraction, the joint space is increased to relieve the pressure on the nerve roots, thus decreasing the symptoms. <ref name="site" /> | As disc height decreases and bone spurs accumulate, the space for nerves to enter and exit the vertebral canal gets smaller. The decreased space can result in greater pressure on the nerve roots or other innervated structures, causing pain and weakness. With distraction, the joint space is increased to relieve the pressure on the nerve roots, thus decreasing the symptoms. <ref name="site" /> | ||
== Evidence | == Evidence<br> == | ||
[[Test Diagnostics|Sensitivity ]] .44 | [[Test Diagnostics|Sensitivity ]] .44 | ||
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[[Test Diagnostics|Specificity]] .97<ref name="Rubinstein et al">Rubinstein SM, Pool JJM, van Tulder MW, Riphagen II, de Vet HCW. A systemic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy. Eur Spine J.2007;16:307-319.</ref> | [[Test Diagnostics|Specificity]] .97<ref name="Rubinstein et al">Rubinstein SM, Pool JJM, van Tulder MW, Riphagen II, de Vet HCW. A systemic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy. Eur Spine J.2007;16:307-319.</ref> | ||
Reliability .88<ref name="Wainner et al">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. 2003;28(1):52-62.</ref> | Reliability .88<ref name="Wainner et al">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. 2003;28(1):52-62.</ref><br> | ||
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | ||
Revision as of 21:40, 9 November 2013
Original Editor - Nikki Arnold
Top Contributors - Admin, Venus Pagare, Nikki Arnold, Kim Jackson, Alyssa Brooks-Wells, Laura Ritchie, Naomi O'Reilly, Kai A. Sigel, WikiSysop, Rachael Lowe, Tony Lowe, Melissa Billy, Dan Rhon and Evan Thomas
Purpose
[edit | edit source]
To test for the presence of cervical radiculopathy.[1] [2]
Test Position[edit | edit source]
Supine
Technique
[edit | edit source]
| [3] |
Patient lies supine and the neck is comfortably positioned. Examiner securely grasps the patient's either by placing each hand around the patient’s mastoid processes, while standing at their head, or place one hand on their forehead and the other on the occiput. Slightly flex the patient’s neck and pull the head towards your torso, applying a distraction force [4] [5]
A positive test is the reduction or elimination of symptoms with traction .[4] [5]
Importance of Test[edit | edit source]
As disc height decreases and bone spurs accumulate, the space for nerves to enter and exit the vertebral canal gets smaller. The decreased space can result in greater pressure on the nerve roots or other innervated structures, causing pain and weakness. With distraction, the joint space is increased to relieve the pressure on the nerve roots, thus decreasing the symptoms. [6]
Evidence
[edit | edit source]
Sensitivity .44
Specificity .97[7]
Reliability .88[5]
Recent Related Research (from Pubmed)[edit | edit source]
Failed to load RSS feed from http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1NqsX9BbHlDlgR7udgNqDhlQmEeZUgyaGQNSWrL_cDi55tOs3r|charset=UTF-8|short|max=10: Error parsing XML for RSS
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination. United States; Evidence in Motion:2008.
- ↑ Malange GA,Landes P, Nadler SF. Provocation tests in the cervical spine examination: historical basis and scientific analyses. Pain Physician. 2003;6:199-205
- ↑ CR Technologies. Cervical Distraction Test. Available from: http://www.youtube.com/watch?v=xDX_TUesdh0[last accessed 09/03/13]
- ↑ 4.0 4.1 Wainner RS, Gill H. Diagnosis and nonoperative management of cervical radiculopathy. J Ortho Sports PT.2000 Dec;30(12):728-744.
- ↑ 5.0 5.1 5.2 http://www.thestudentphysicaltherapist.com/cervical-distraction-test.html Cite error: Invalid
<ref>tag; name "Wainner et al" defined multiple times with different content - ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedsite - ↑ Rubinstein SM, Pool JJM, van Tulder MW, Riphagen II, de Vet HCW. A systemic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy. Eur Spine J.2007;16:307-319.
