Spinal Care Plus — Functional Tests

S p i n a l C a r e P l u s		L o n n i e J o h n s o n DC eliminate back pain with functional testing and targeted exercise

Treatment
          Medication
          Manipulation
          Red & yellow flags
          Functional tests
          Active exercises

About

Functional Tests

Functional testing is designed to discover the root of the back pain problem. The tests are listed by name. For each one you will find a detailed description, photograph, pass/fail criteria, and recommended active exercises. The tests can also be used to evaluate progress with exercise or therapy. These tests and much more can be found in Rehabilitatin of the Spine: A Practitioner's Manual by Craig Liebenson, DC.

Active Single Leg Raise
Forward Lunge
Janda's Hip Abduction
Janda's Hip Extension
Modified Thomas
Reflex Stability
Side Bridge Endurance

Single Leg Balance
Single Leg Squat
Squat
Thoracic Mobility Screen
Trunk Exterior Endurance
Trunk Flexion Coordination
Trunk Flexor Endurance

Active Single Leg Raise

Test: Supine 10" SLR

Fail: SI pain, trunk rotates toward leg (weak obiqeabs)
Grade strength with resistance

active single leg raise test

Recommended targeted exercises:

Stretch psoas hip flexors
Bridges
Core strength
Squats
Lunges
Two-hand cable twist

Forward Lunge

Test: Step forward and put back one knee to floor, then rise.

Fail: inability, poor balance, trunk flexion, ankle knee pronation

forward lunge

Recommended targeted exercises:

Stretch psaas (hip flexors), anterior hip valgus beyond toes

Balance:
Lunges, angle forward lean step

Janda's Hip Abduction

Test: Side lying raise leg to ceiling.

Score: cephalad pelvis shift at imitiation = Qh substitution
1st 40 degrees
a) hip flexion = TFL
b) hip ext rof = piriformis
c) pelvic rotation = g med weak
d) redweed < 40 degrees = adductor tight
Grade resistance at 20 degrees

janda's hip abduction

Recommended targeted exercises:

Relax TFL piriforms adductors Qh IT band

Facilitate:
G. Medices
Balance:
Balance training
GMed balance reach

Janda's Hip Extension

Test: Prone lift leg to ceiling.

Fail:
Anterior pelvic tilt at initiation
2. Lumbar hyperextension or trunk rotation before 10 degrees
3. Knee flexion (hamstring substitution)
4. Delayed g max
Grade strength at 10 degrees

janda's hip extension

Recommended targeted exercises:

Stretch hip flexors, hamstring
Rocker board
Bridges, core/trunk
Squat, lunge

Modified Thomas

Test: Knee to chest and lie back on table with other leg dangling off.

Score:
Thigh horizontal – tight hip flexors
Knee 790 degrees tight rectus fenoris
Thigh horizontal knee <90 degrees – iliopsoas
Thigh abdustion – TPL adduction single joint adductors

modified thomas

Recommended targeted exercises:

coming soon

Reflex Stability

Test: Lean forward without bending at the waist.

Fail: delayed or absent gripping of toes

reflex stability test

Recommended targeted exercises:

Adjust foot
Balance reach
Functional lunges

Facilitate:
Inchworm
Rolling towel
Pick up pencil

Sensory motor:
practice test with side-to-side swaying

Side Bridge Endurance

Test: Side lying, only forearm on ground.

Score: <45 sec. fail; side-to-side difference >5 sec.

side bridge endurance

Recommended targeted exercises:

Stretch hip flexors anterior hip
Side bridges

Single Leg Balance

Test: The examiner instructs the patient to stand on one leg. After 10 seconds the patient is asked to repeat the test standing on the other leg.

The second part of the test is to stand on one leg with eyes closed. The repeat on the other leg.

Fail: If the patient is unable to stand on one leg for 10 seconds without shifting stance leg or dropping the other leg to the floor. Test can be repeated three times with the longest successful time for each leg noted.

single leg balance

Recommended targeted exercises:

Rocker foot
Balance reach
Functional lunges

Single Leg Squat

Test: One leg mini squat (may use support)

Fail: inability, pronation, knee valgus, beyond toes, trendelenberg

single leg squat

Recommended targeted exercises:

Reflex/stretch, piriformis, IT & TFL, posterior hip release

Facilitate:
Gmedius, single leg bridge

Balance:
Single leg squat

Squat

Test: Place your feet apart at shoulder width, with arms ahead or supported. Squat until your thighs are parallel to the floor.

Fail: < depth of squat, hyperpronation, knee valgus, knee beyond line of toes (hip capscele tight) lumbar hyper ext/flex

squat

Recommended targeted exercises:

Bridges
Squats
Lunges

Thoracic Mobility Screen

Test: Stand with back to wall feet 6" from wall, arms overhead, tight core.

Fail: lumbar hyperextends, arms do not reach 180 degrees

wall angel

Recommended targeted exercises:

Relax/stretch latissimus pectorals
Breathing exercises
Stabilize core
Dead bug
Overhead cable pull down

Trunk Exterior Endurance

Test: As is at table edge ankles supported, extend spine to horizontal cm.

Fail: <60 seconds, less than trunk flexor time or side bridge

trunk extensor endurance

Recommended targeted exercises:

Relax/stretch hip flexors (psoas)

Facilitate:

Trunk extensors
Gluteus max (Bridge)
Hamstrings (curl on ball)

Trunk Flexion Coordination

Test: Supine perform curl up (dr. ccm cup heals) knees bent.

Fail: feet rise from table before scapulae

Recommended targeted exercises:

Stretch hip flexors (psoas)
Stabilize core
Dead bug

Trunk Flexor Endurance

Test: Sitting one knee bent ankles supported 50 degrees.

Fail: <50 sec, < side bridge endurance

trunk flexor endurance

Recommended targeted exercises:

Stretch psoas
Strengthen core
Dead bug