Diagnostics - Scan Lower
Motion Testing: Sidebending and Rotation from the Forward Bent Position (Flexion)
If something interferes with the capacity of either facet to open normally, restriction of forward bending will occur. For example, if a right facet does not open normally, but the left does open normally, right sidebending will be possible but left sidebending will be restricted in the forward bent position. In the cervical spine during flexion/extension, sidebending and rotation are coupled movements in the same direction. Therefore, rotation will also be affected by facet joint dysfunction. If the right facet does not open normally, we would expect to encounter abnormal resistance with left to right translation in the forward bent position. If the left facet does not open normally, we would expect to encounter abnormal resistance with right to left translation in the forward bent position.
To test for a restriction to sidebending in the forward bent position:
- The examiner should grasp the patient's head using the heel of the hands. The examiners fingertips should be placed over the posterior aspect of the articular pillars of the superior vertebra of the motion segment that is to be tested.
- The examiner should then rotate the patients head forward on C1 and forward bend the neck down to the level of the segment that is being tested. Envision the axis of forward rotation as being located at the level of the segment that is being tested.
- While maintaining the cervical spine in flexion, the examiner should introduce translation to the right and to the left. Avoid cocking the head to one side or the other.
Join Dr. Philip E. Greenman, D.O., F.A.A.O., as he demonstrates translational motion testing in the forward bent position and then evaluates the results of his examination.
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