The SLUMP Test | Neurodynamic Testing
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- Опубликовано: 28 май 2024
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This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. The Slump test is a neurodynamic test used to assess neurological symptoms such as sciatica, tingling, numbness or burning sensation in the lower limb possibly caused by a hernia or nerve root entrapment.
Article:
www.ncbi.nlm.nih.gov/pubmed/20...
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You have no idea how much this channel helps us🙏
You guys are legends have helped me so much with my studies 📕
Thank you so much I am physio student this is very helpful for exam
Really??
@@marifatkhan6889no
Ur channel deserve more subscribers
And wish u add more info about the conditions and it's management (acute-subacute-chronic) for rehab
+PDC Ghada thanks! That's something we are already working on and a lot of people ask! So we'll get into rehab soon
you guys are amazing.. love your videos....
great job guys, really like your videos, very precise. keep it up. thumbs up
+BIGTATAN1 thanks a ton we appreciate it!
Am Using Physiotutors for my Examination. Its very useful for me.thank you.
thank you so much for this vlog very informative
Thanku so much sir your all videos are very helpful. Keep it up 👍👌👌
yeah thank you so much sir...my interest is purely in sports so Physiotutors is a perfect channel for me...I expect your same support in future...thank you so much
Very nice meeting you and this looks good!
Hope to see you again - Lineke ;)
Thanks, see you guys during the next RUclips event!
Afgesproken!! ;)
hello guys ,, love this video and slump test is so easy,, in other references they have slump test 1-4...hope you can load theses variations in the future .. again thank you and you are really helping me a lot at present in my reviews.. God bless and more power
Hey Aerine Colonel, glad you like our video! We assume that you are talking about the modifications to test stress various peripheral nerves? To our knowledge this is not validated, but it's definitely an option for further videos!
Thank you sir .your videos helping me a lot
You’re welcome 😊
Thank sir.... For helping me
I have extraordinarily tight hamstring muscles. With my legs straight, I can barely reach my knees. Forty years ago I was taking a nap in an 18-wheeler truck that didn't have a sleeper berth. I was laying across the two seats and had my feet propped up on the passenger side window frame. As I was drifting off to sleep I felt a sudden piercing pain in the sacrum area. And I have been living with it ever since. Multiple MRIs of the lumbar spine show no disc impingement. Sacrum MRIs, they say, are unremarkable. But the pain is real. I feel the pain mainly when laying on my back. I can only tolerate a few minutes on my back without a piecing pain in that one spot. If I continue to aggravate the source of pain, whatever it is, I experience sciatica that goes down into the foot. I have gotten no help from doctors.
Thank you for the info ..my question to you is how accurate is SLR to diagnose slipped disc & what is SLR,seated leg raises,slum test,bend forward & backward , dorsiflexion tests are negative?
Discs so not slip so every test is negative
Thanks
Tx!
Hi from So Cal (Southern California University of Health Sciences/Los Angeles College of Chiropractic)
can you make videos on the different scales used for joints and musculoskeletal conditions
We have a couple of videos in our clinimetrics playlist that you could check out. Do you mean questionnaires or anything specific?
@@Physiotutors
Yes sir I meant disease and joint specific questionnaires and scales .
Can anyone create a client symptom picture...which would print when to do the slump test!? That's where I am confused. I understand when to do tests for TOS or vertebral deficiency...
thanks for saving me in my exams
Good afternoon. I have a hernia L5-S1. When I do this test, there is a characteristic pain in one leg, but no pain in the other. It appears exactly where the ischial nerf is located. How to help yourself? I have not been able to sit for a year, the terrible pain interferes.
What have slump test, SLR test , dorsiflexion test,bending test,reverse leg raise test are negative
Hi, I love the videos and assessments. I need some help please, were can I find some evaluation of these tests, and evaluation of any physio assessments regards to function, validity and reliability. I am looking for references and scholarly articles. Thanks for the help.
They’re all in our assessment ebook and mobile app
Check it our here: bit.ly/GETPT
We cover validity and reliability for each test where the literature is available. Including reference to the article
is tension on the lateral side of the leg that gets stronger with neck flexion pathological?
Finally a test I actually went through! It wasn't a good result for me. I have a degenerative slipped disc in my L5 and L6 area. Do you have any SI joint dysfunction tests or piriformis dysfunction tests?
L6 area doesnt exist
@@saidgutierrez2253 Some people have an L6.
Please upload millgram test
that was awesome, but i want to ask what is the meaning of positive slump test and negative SLR test ? what is the interpretation ? thank you
Good question. Remember that tests are made to test out a hypothesis, so in case of a hernia with nerve root compression (positive on shooting pain) we wouldn't recommend to do the SLUMP test, but rather the SLR and crossed SLR, as according to our literature (van der Windt et al. 2010) the SLR + crossed SLR have better statistical values.
In general the Slump Test certainly puts more stress on the dura and the spinal cord and might be used to detect the source of nociception based on referred pain pattern that is reproduced. Don't have any really good source other than the innervation of spinal structures. so based on the innervation, one could reason the following:
- Referred pain in 8 or more spinal segments bilateral --> Dura (in case of dural adhesions for example)
- Referred pain 2-3 segments bilateral --> intervertebral disc
- Referred pain 2-3 segments unilateral --> Ipsilateral facet joint
- Referred pain in 1 segment unilateral --> Ipsilateral Dural sleeve
@@Physiotutors how about positive slr negative slump? what does this mean? thanks
I have l5 s1 herinated disc abou 2 months i feel better now after going to PT. But when i try this test i have lower back pain also when trying straight leg raise like 3% pain for the left leg and 1% for the right leg like a "discomfort" not pain! Any suggestions
Great video guys! Question: in this video, you ask the patient to actively extend the knee. In your physical assessment book (and the way that I learned elsewhere), it states to the examiner to passively extend the knee (prior to dorsiflexion of foot). Does this matter? Would you recommend one way or the other? Thanks again guys!
Hey Sun, yes - officially it's a passive test and we might have to do a remake thinking about it now.
You'd actually dorsiflex and then slowly extend the knee passively.
It does matter as a provocative test is always performed by the examiner as a patient obviously does not want to provoke his pain/symptoms.
Have a look at our Slump variations video which gives a more in depth explanation what is actually happening in the tissues with different build ups of the slump!
Physiotutors thanks for the response! So very helpful
No worries - good remark!
@@PhysiotutorsHave you seen anyone who could not lift his leg in this position but with time and rehab he was able to perform this slump test?????? (I have a disc extrusion )
Great ' thank you
ur welcome!
Nice meeting you guys at the Creator day in Amsterdam. Your channel looks great ( subbed ! )
Mike Hermes
+Mike Hermes thanks a lot mike! We will keep you in mind for a collab!
Keep doing what you are doing guys, looks great !
What does it mean if my slump test is definitely positive? How can I treat the issue?
Hey Physiotutors, in the case of symptoms increase with cervical extension would you put that down to an 'interface' structural pathology i.e. the nerve being compressed and when in cervical flexion this actually moves the nerve away from the structure reducing symptoms when extending the neck.
Lastly, when would I choose to perform a SLR as opposed to the SLUMP? I assume the SLR is a regressed assessment to the SLUMP and would be more appropriate in patients who are deemed irritable?
Hi Thomas, that could very well be the case yes. Also gotta differentiate what kind of symptoms...fitting cervical radiculopathy or myelopathy even?
hello sir...I am a Physiotherapy student from India... I've seen all the videos of this channel. It is my favorite channel..could you plz upload the videos on PNF patterns of various joints....it will be very helpful ....Thank you...
Really cool to hear that we´re you´re favorite channel shishir. PNF is not really our specialty to be honest, maybe we can find someone who is a specialist in it and shoot a video about it with him/her.
Hey
Aren't we suppose to gv over pressure to the cervical region after leg extension and dorsiflexion.. Some books gv dat sequence.. Which is best?
That's true that different books recommend different sequences.
Have a look at our Slump test video with distal and with proximal explanation to learn what difference the sequence can potentially have!
This test also stresses the meninges, right?
What does slump test indicate if I have a painful stretch in my right calf? Thanks for the help
The stretch you feel there might be a points where tension is greatest on the nerve tissue (tibial nerve)
@@Physiotutors thank you so much.
I have right foot aversion and right knee pain, right gluteus mediums is weak and smaller, my pelvis is lower on right side. This caused neck pain and affected my Whole right side.
How would you use this test to differentiate between reffered pain and neurological pain?
check out our video on referred vs radicular pain. They each have distinct features. If you want to read more we can recommend the Paper by Bogduk: pubmed.ncbi.nlm.nih.gov/19762151/
I have severe shooting pain in my upper glute when i just look down while my leg is straight. Trying to do slumped makes it much worse. Doctors haven’t been able to figure out what’s wrong… been like this for >1 year
Oh god same bro!!!!!
I had disc extrusion 9 months ago,lets connect
Thanks xoxo
No worries, thanks for subscribing!
Sir,can u tell me how to take physiotherapy assessment of patients?
Out whole channel is about assessment
Is it possible that the patient may have discomfort with only slouching and/ or flexion of neck? Can you passively dorsiflex the foot and ask patient to actively extend the knee? I feel it produces more tension over the nerve? Is it correct tho?
Everything is possible. The question is what your outcome is that you are rating. The Slump test is a neurodynamic test so a positive outcome are neurological symptoms.
There are different descriptions of the Slump. We'd suggest to do dorsiflexion and knee extension passively, which is also why we are thinking about a remake.
Do u have any information about Facet joint syndrome?? What special tests for this condition? I learned
To use slump and straight leg raise teat ??
Please help to understand the facet joint syndrome?? What is it exactly??
Facet joint syndrome is when your facets become swollen and painful mainly due spondylarthrosis. This often causes local one-sided pain in the spine, as well as referred pain (dull, aching, proximal > distal).. As this is no neuropathy, the SLR will not be useful here, the Slump would also be not our go to test.
To test the facets, you are trying to compress them maximally (3D extension movement) and/or stretch their capsules maximally (3D flexion movement).. This is for example done with the Kemps test.
We are about to shoot a lot of videos on manual therapy techniques and will definitely go deeper into that topic!
I have a clinical exam and one of the scenario is facet joint syndrome
So I will apply Mobs (maitland)
Stiffness grad 3 or 4
Pain grade 1 or 2
My question is which is better to perform grade 3 (large amplitude) or grade 4(small amplitude)
At uni they say small is better if there is pain but they didn't say why? So why? And which is better
Thanks
Usually you apply mob grade I-II in case of pain with the goal of pain reduction and grade III-IV in order to mobilize - so basically what you said.
In case of pain you won't be able to mobilize grade 3 or 4 anyways. Which one of them is better - no idea. The question is also if you are able to make such subtle differences at all.
Yes special test for facet joint syndrome is kemps test aka lumbar quadrant test
Physiotutors slump test is positive for which condition plzzz tell me
What functional tests would you consider for a herniated disc?
Not really sure what you mean with "functional" - like in "related to activities of daily living"?
In that case the finger-floor distance is a "functional" test that is recommended by the guideline of the Dutch Royal Society of Physiotherapy for low back pain.
In general, the typical tests to confirm and rule out a herniated disc with nerve root compression are the Straight Leg Raise Test and the Crossed Straight Leg Raise test although their validity is also low.
@@Physiotutors whats about Kemps test?
Hi, so about 2 weeks ago, i hurt my back a little. for the first day or two my back was sore when bending over but that has completely gone away, now i have no pain during anything except for the slump test. Pain is only in the lower back, and it is not severe. No pian in Butt or legs whatsoever. Could that be a sign of a herniated disc still?
Low back pain has a good prognosis and mostly goes away on its own.
No, a herniated disc pressing on a nerve root would cause shooting pain down the leg in the slump test.
Keep moving and slowly progress your activities back to your old level and you should be fine.
@@Physiotutors What if it's not a shooting pain but more like discomfort(tight) in glute medius or somewhere around upper buttock and lower back when soing the slump test?
I have a problem on my back due to which my left shoulder feels kind of hanging free on left side and on the left side of sc joint my coller bone makes sounds on contracting and retracting the shoulder. PLZZ REPLY¡!!!!!
For any personal health or rehab questions we recommend to consult with our partners at yourphysio.online for a remote physiotherapy consultation.
Have you seen anyone who could not lift his leg in this position but with time and rehab he was able to perform this slump test?????? (I have a disc extrusion )
Nice video :) Could you please make a video test for red flag ? Thank you😇☺️
Check our video on screening where we discuss red flags
How useful is this test in actual practice???
Not useful (too provocative) to detect HNP with root compression but useful in detecting minor neurological impairments such as in the dura or Dural sleeve
This test is positive in low back pain???
This is very probable, but you want to use a test to confirm a hypothesis or reject it.
So a hypothesis that could be confirmed for example is: Patient has radicular pain due to a disc prolapse, extrusion with nerve root compression.
What country are you guys from?
Both German living in Amsterdam
my butt really hurts when i did this, what symptoms do i have?
Might be hamstring tightness. What kind of pain did you have?
@@maccox9382 Mine too, just at one point in middle of butt
Me 2 what do i have?
(update) um guys idk about this but sleeping without pillow relieve the pain for me, and (atleast) until now i never had a back pain again
@@Vebian so no one knows if there's pain in his butt, is that positive test?
Is the patient single? ;)
thats a pretty mediocure specificity. Do you feel this is a useful test?
There's other tests that can be done, this is just one of them. The physical therapist must choose the one that he/she thinks is better for the pacient, since there's a lot of problems a pacient can have, and each test can confirm different pathologies
Andreas you're handsome;)
gj
LODICAKES
Sir...speak clear ,loud and openely...don't eat words at the end of sentence... Since we are not getting some words clearly..
There is always a subtitle option if you have difficulties understanding the words
@@Physiotutors ok..thank you..
Thanks