Rehab Test Summary

8/2/2019 Rehab Test Summary

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SUBJECTIVE COORDINATION TESTS

Movement Pattern Patient Position Instruction Pass Fail

Hip extension

NB. Look at first

10 of extension -amount of hip

extension that

should be present

when walking

Prone, feet off the

table, head turned

to a comfortable

position

Keeping your leg

straight, slowly lift

your leg in the air

- Sequence of muscle contraction

1) Ipsi hamstring2) Ipsi glut max (can fire 1st)3) Contra lower erector spinae4) Ipsi lower erector spinae5) Contra upper erector spinae6) Ipsi upper erector spinae

- Axis of rotation in the hip

o Delay of glut firingo Weak agonist = glut maxo Overactive agonist = psoas and rec femo Overactive synergist = hamstringso Overactive stabiliser = erector spinaeo Muscle activation above T8 (severe fail)o Axis of rotation in lumbar spine (over

stress of lumbars when walking)

o Rehab goalsrelieve excess stress onlumbar spine

Hip Abduction

NB. Note that the

arc is 30

fromneutralthe patient

starts in adduction.

Important for

lateral stabilisation

of pelvis in gait.

Side lying with

bottom leg bent for

support

Top leg in line

with torso

Keeping your leg

straight, slowly lift

your leg straight inthe air

o Hip raises in a smooth arc to 30degrees of abduction before the

iliac crest shifts superiorly (hip

hike)

Agonist- Glut med, minAntagonist- adductors

Stabilisers- QL

Synergist- TFL

Neutraliser- piriformis

o Flexion of hip (with or without externalrotation) = tight TFL

o Torso rotation posteriorly = tight psoaso Early hip hike = tight QLo Ext rot of the foot with no hip flexion =

piriformiso Wobbling of leg = weak glut med- Indicative of poor stabilization during the

One Leg Stance of the gait cycle - causes

increased lateral shearing forces on the

spine

Trunk flexion-

interplay between

psoas and abs.

Supine with slight

knee flexion and

heels contacting

bench

Keeping your arms

forward, slowly curlup like a sit up

The scapula clear the table 5cm

before the feet lift from the table

The feet lift from the table before the

scapula clear = poor coordination of

anterior trunk stabilizers, results in

increased requirement from postmusculature (tight lumbar erector spinae)

and hip flexors (psoas). L flexionrestriction.Draw bridge sign- instead of curling there is

an anterior pelvic tilt with either a flattened


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L lordosis or an increase L curve.Shoulder

Abduction

NB. Make sure ptnt

relaxes shoulder

between lifts

Seated, elbow

flexed to 90

degrees

Slowly raise your

arm to you sideShoulder abducts to 60 BEFORE

shoulder elevates. First 30-60 pure

glenohumeral rhythm, stabilised by

upper traps, then scapula rotation-

inf angle moves laterally. Scapulashould stay against Tx cage

Agonist- Mid/lower traps

Synergist- upper traps/lev scap and

rhomboid

o Excessive contraction at 30-45 - overactivity of upper traps and levator scap

- Increased load on the cervical spine

- Can indicate a G-H jt problem

o Scapula moves superiorlylev scaphypertonicity

o Scapula moves sup and medrhomboidhypertonicity

o No scap rotationupper trapshypertonic and lower and mid traps

weak

o Wingingserratus ant weaknessNeck Flexion

NB. Watch that ptnt

is curling with chin,

not trunks

Supine Slowly bring your

chin to your chest

Nice smooth arc with chin going

towards chest (in first 10 degrees)

Agonist- DNF

Antagonist- sub occ.

Synergist- SCMs

Chin jutting within first 10 of motion

- Inhibition of DNF compensated with

overactive SCM/tight suboccipitals- Poor Co-C1 function (proprioceptive

disaster!)

Push up Starts in prone

position, hands

under shoulders

Keeping your

knees in contact

with the ground,slowly push your

body up

Scapula are stable with minimal

movement and no winging

Shoulders retract, protract, elevate or wing

- Leads to poor stabilization of the shoulder

girdle with unstable motion of the upperextremity; Overstress of neck and rotator

cuff mm; use of one arm over the other

- Tight pecs

Winging, kissing scap- weak serratus

Elevation- OA upper trap and lev scap.

Excess protraction/ ant tilt- OA pec minor


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Subjective

Coordination Test

Patient Position Instruction Pass Fail Findings related to

which movement

pattern

(Vleemings) Active

Straight Leg Raise

Supine Raise one leg

slowly, keeping

your knee

straight

Pelvis should remain

neutral. C/L EO

Abs and I/L IO

Movement of pelvis on opposite side to

leg raise, and/or flaring of the

ribs/ribcage on the homolateral side.

Related to weak internal oblique chains

Trunk flexion

- Psoas and Lx

erectors tight

Squat Standing, feet

shoulder width

apart, feet flat

Patient should be

able to squat to 90

degrees with torsoremaining upright

and heels on theground

o Heels lift upshortsoleus/gastrocnemius

o Torso leans forwardGlutmax/Torso coordination issues

Weak abs/tight upper backKnees- anterior=patellofemoral shear

Valgosity- weak/inh gluteals allows i.r

Lspine- excess flexion= tight posthip capsule or weak/inh L erectorsIncreased lordosis- tight erectors,

psoas and poor ant stab.

Trunk flexion

- Psoas and Lx

erectors tight- Gastroc lengthening

Lunge Standing

initially

Take a larger

than normal stepforward, and then

get your back knee

to touch the

ground

Spine should drop

straight down withthe knee

Anteversion of the hip = tight adductors

Knee roll/hip abduction = weak hipinternal rotators e.g. (synergists) TFL,

vastus medialis

Foot pronates = weak tibialis anterior

Trunk flexion

- Psoas and Lxerectors tight

Hip abduction (knee

roll)

Veles foot reaction Bare feet, Lean forward from Equal reaction of toe No reaction or diminished in one foot- Veles foot reaction


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(holding table) continue to squat

once every 2-3

secs

Repeated curl Supine, hooklike

position.

Practitionerstabilises above

ankles

Slowly slide your

palms (thenars) up

your legs to thetops of your knees,

and repeat onceevery 2-3 secs

Average is around 30

Max = 50

2 mistakes Trunk flexion

Static Back Extension

(Sorensons)

Prone, ASIS in

line with top of

couch, Dr

supporting mid-

calf

Hold horizontal

position (allow for

only one

correction)

2min normal

4min max

Tests erector spinae Trunk flexion

Side Bridge endurance

test

Sidelying resting

on bottom

elbow. Bottom

leg bent and hipflexed. Body in

straight line.

Lift Pelvis off

couch as high as

you can and hold

for as long as youcan.

90 secs. Pt can hold for 90 secs. Hip abduction

Julls DNF Test Supine, head off

the couch

supported by Dr.

in horizontal

plane

Hold your head

in this position

once I take myhands away

Holds head in same

horizontal plane for 4

secs without shaking.

o Chin juts forwardo Head lifts or drops back (be

prepared to catch)

o Excessive shakingo Overactive SCMs and

suboccipitals

Neck Flexion

Kendalls upperabdominal strength

test

Supine, hooklying position,

with ankle

stabilisation

Sit up in thisposition

Graded out of 5.2- poor unable

3- fair arms

outstrectched

4- good arms crossed

5- normal arms

Trunk flexionmovement pattern


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behind head

Kendalls Lower

abdominal strength

test

Supine, flatten

lumbar lordosis,

90 hip flexionand knees

extended

Lower your legs to

the table while

keeping your low

back flat.

Graded out of 5.

2- poor unable to

flatten back

3- fair lordosis forms

at 90- 454- good lordosis

forms at 45- 05- normal no increase

in lordosis.

Documents

Rehab Test Summary