Some special tests can be modified to be done via telehealth. Below we have provided photos and instructions as guidance on how to perform these special tests.
Supine self-administered special hip tests:
Intra-articular hip pathology:
FABER test, or figure-4 position: to address intra-articular hip pathology as well as provoke possible sacroiliac joint-generated pain.
Active SLR test: Patient-applied resistance to SLR can also be added to create a modified form of the Stinchfeld test, which is a provocative test for intra-articular hip pathology.
Modified flexion adduction internal rotation (FADIR) test/labral scour: The patient pulls tested hip into flexion and rotates toward the opposite iliac crest. This is also a provocative test for intra-articular hip pathology.
Modified logroll test: The patient externally and internally rotates foot to rotate the femoral head.
Modified Thomas test: Patients can perform this test on themselves; the test consists of pulling the femur on the tested side into full flexion and observing whether hip remains in the neutral/flat position on the opposite side.
This test assesses the patient’s hip flexor muscle length
Popliteal angle: While lying flat with the hip flexed to 90, a towel can be used to provide maximum stretch to the hamstring toward full extension and the residual popliteal angle (measured from 0) can be assessed.
This test assesses the patient’s hamstring muscle length
Sacroiliac joint assessment:
Modified Gaenslen test: If able, the patient can hang the symptomatic leg off the bed or table, and if able, the patient can pull the opposite knee to the chest to increase shear stress on the sacroiliac joint. This test may indicate sacroiliac joint pathology if pain is reproduced.
Seated self-administered special hip tests:
Hip range of motion:
Hip flexion can be performed actively with the patient’s help to provide optimal stretch/range of motion.
A FABER test in the seated position, or figure-4 position, can be used to address hip external rotation.
A towel wrapped around the ankle can assist in pulling the lower leg out to the outside as an assessment of hip internal rotation. The thigh should be held as stable as possible and perpendicular to the pelvis during this assessment.
FABER test in the seated position can also be used to address intra-articular hip pathology.
Seated SLR test can be used to assess hamstring flexibility (seated popliteal angle) as well as to provide dural provocation in the assessment of lumbosacral radiculopathy.
Modified hip FADIR/labral scour test can be performed by holding the knee to be tested and pulling the knee into flexion and rotation toward the opposite hip.
Hip flexor strength/pain provocation for 5 seconds can be assessed by flexing the hip upward against a stationary object, such as the underside of a desk and opposite hand.
Laskowski, E., Johnson, S., Shelerud, R., Lee, J., Rabatin, A., Driscoll, S., Moore, B., Wainberg, M., Terzic, C. (2020). The Telemedicine Musculoskeletal Examination. Mayo Clinic Proceedings, 95(8), 1715-1731.
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