Movement Control Tests For Lumbar Spine

Original Editor - Carin Hunter based on the course by Nick Rainey
Top Contributors - Carin Hunter, Rishika Babburu and Jess Bell

Introduction

Tests are considered positive if with cueing and demonstration the person can not perform correctly.

Six Movement Control Tests

1. Waiter’s Bow:

Correct: Forward bending of the hips 50-70°  without flexion of the low back.

Incorrect: Flexion occurring in the low back prior to 50° of hip flexion.

2. Sitting Knee Extension:

Correct: Upright sitting with lumbar lordosis; extension of the knee to within 50° of straight without movement of LB.

Incorrect: Low back moving in flexion prior to within 50° of straight.  

3. Rocking backwards:

Correct: 120° of hip flexion without movement of the low back by transferring pelvis backwards.

Incorrect: Hip flexion causes flexion in the lumbar spine (typically the patient not aware of this).

4. Prone Lying Knee Flexion:

Correct: Active knee flexion at least 90° without extension movement of the low back and pelvis.

Incorrect: Low back does not stay neutral, but moves into extension

5. Posterior Pelvic Tilt:

Correct: Posterior pelvic tilt the pelvis while in standing by contracting the glute max while keeping the thoracic spine in neutral

Incorrect: Pelvis doesn't tilt or low back moves towards Ext./No gluteal activity/compensatory flexion in thoracic spine

6. Single-leg Stance:

Setup: Patient’s feet 12cm apart. Use a 20cm ruler and hold it on a stable object with the middle of the ruler lined up with the patient's umbilicus.

Correct: The patient’s umbilicus has <2cm difference side to side and <10 cm transfer on either foot.

Incorrect: Lateral transfer of belly button >2cm difference side to side or > 10 cm in either direction .

Articles:

• Luomajoki H, Kool J, De Bruin ED, Airaksinen O. Reliability of movement control tests in the lumbar spine. BMC musculoskeletal disorders. 2007 Dec;8(1):1-1.
• Meier R, Emch C, Gross-Wolf C, Pfeiffer F, Meichtry A, Schmid A, Luomajoki H. Sensorimotor and body perception assessments of nonspecific chronic low back pain: a cross-sectional study. BMC Musculoskeletal Disorders. 2021 Dec;22(1):1-0.