SPECIAL TEST FOR CERVICAL REGION

Shoulder abduction test or (Bakody sign)

Aim: compression of the neural structures with in the intervertebralforamen.

Patient position: sitting

Therapist position: standing in front of patient

Procedure: the examiner passively or patient actively elevates the through abduction so that the
hand or forearm rest on the top of head. Positive findings decrease in symptom of upperlimb. If
increases it implies increase pressure in the interscalene traingle.

Indication: herniated disc, nerve root compression usually C4 -C5 or C5-C6, acute neck pain.

Incidence: 92%

Jackson's compression test

Patient position: Sitting position

Therapist position: Examiner is at the back of the patient

Procedure:The patient rotates the head to one side.The examiner then carefully press straight down
on the head

Indication : cervical radioculopathy disc pathology

Incidence: 88%

Distraction test

Patient position- sitting

Therapist position- standing side of the patient

Procedure-

 Examiner places one hand under the patients chin and the other hand around the occiput.
 Now slowly lifts the patients head by applying traction to cervical spine.
 As cervical spine is distracted it relieves the pressure on nerve roots.
 so the Radicular pain (or) the symptoms is reduced.
 Then the test is defined as positive.

Method 2:

 This test is also used to check the radicular signs referred to shoulder complex.
 while tarction is applied patient is asked to abduct the arm.
 If the pain increases then it is reffered to any muscle spasm, ligament sprain, muscle strain,
dural irritability.
Indications:cervical radiculopathy.

Incidence:88%

Vertebral artery test

Patient position: sitting or supine position.

Therapist position: Examiner is at the back of the patient.

Procedure: The examiner takes the patient head and neck into extension, right and left rotation and
side bending.

Hold each position for 10-30 sec unless symptoms are evoked.

Positive sign: Dizziness, visual disturbance, disorientation, slurred speech, nausea, vomitting.

Indication : vertebrobasilar insufficiency.

Sensitivity:0% , Specificity:67%-90%.

Cervical flexion and rotation test

Aim : To asses dysfunction at c1 & c2 motion segment

Patient position – Supine lying

Therapist position – Above the patient’s head.

Procedure:-

 Patient is relaxed in supine

 Examiner fully flexes the cervical spine with the occiput resting against the examiners
abdomen
 The patient’s head is then rotated to the left and the right
 If a firm resistance is encountered, pain provoked, and range is limited before the expected
end range, then the test is considered positive, with a presumptive diagnosis of limited
rotation of C1 on C2

Indication: neck pain, head ache migraine

Incidence -92%

Shoulder depression test

Patient position : sitting on the arm rested chair

Therapist position : Therapist stand behind the patient

Procedure: patient asked to sit in comfortable position and (for example)if pain on right side
therapist one hand side flexes the head on one side other hand placed on opposite (left) shoulder
and apply downward pressure on the shoulder
Indication : Indicates pain, irritation and compression

Incidence: cervical Radiculopathy, brachial plexus lesion, one or more nerve root compression.

Valsalva Test

Patient position : Sitting, supine or semi – recumbent position

Therapist position : In front of the patient

Procedure: First take a normal, deep breath, hold the breath, close your glottis, then exhale against
your closed glottis (close your nose and mouth) or as bearing down. It is done for 10-15 seconds
followed by normal breathing.

Indication : Radicular pain

Incidence: Sensitivity 22%, specificity 94%.

Hautant’s test

Patient position: Sitting

Therapist position: Standing side of the patient

Procedure :

1. Method 1 :
 The patient sits and forward flexes both arms to 90°
 The eyes are then closed.
 The examiner Watches for any loss of arm position.
 If the arms move

Inference: Nonvascular.

2. Method 2 :
 The patient sits and then asked to rotate, or extend and rotate, the neck.
 This position is held while the eyes are again closed.
 If wavering of the arms occurs.

Inference : The dysfunction is caused by vascular impairment to the brain.

Each position should be held for 10 to 30 seconds.

Incidence :