Physical Examination Of The Spine & Extremities. Physical Examination Of The Spine & Extremities. Stanley Hoppenfeld View or Download (PDF) [English]. EBOOK [#PDF] Physical Examination of the Spine and Extremities of the Spine and Extremiti) >>DOWNLOAD For download this book click. Physical Examination Of The Spine & Extremities. Pages · · MB · Downloads ·English. by Stanley Hoppenfeld. Preview Download.

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The literature regarding leg-length inequality as a risk factor for RRI is equivocal in adult competitive and recreational runners 11 - 21 and military training populations. The author has previously reported on several risk factors in a large prospective observational cohort study. Thus, the primary purposes of the current study were to 1 describe the prevalence of leg-length inequality among female and male high school cross-country runners, and 2 to determine whether leg-length inequality was associated with increased RRI in female and male high school cross-country runners.

Additionally, as the evidence for whether side of inequality is related to injury is mixed in adult running or military populations, 17 , 18 , 29 - 35 side of inequality was examined to determine if the shorter or longer leg limb was associated with side of running-related injury in female and male high school cross-country.

Further, as body mass index has been associated with RRI, 36 , 37 particularly lower leg RRI, 38 - 40 its influence on the relationship between leg-length inequality and RRI was assessed.

Four hundred twenty-one runners females, males , who competed on their teams during the high school cross-country season and were free of symptoms from any RRI at the time of the measurements, participated in the study.

Parental consent and athlete assent was obtained for each subject prior to the baseline measurements. During the course of the season, 28 runners 15 females, 13 males did not finish the season due to noninjury i.

Thus, complete data for runners females, males were used in the final study analysis. Data Collection Leg-Length.

Just prior to the season, the main investigator went to each high school at a scheduled meeting time and place to measure their school's runners' leg-lengths. The leg-length of both lower extremities for all runners were assessed with the subject in the supine position where each runner's absolute leg-length was measured with a cloth tape measure from the anterior superior iliac spine to the medial malleolus and recorded in centimeters.

The intrarater intraclass correlation coefficient ICC 3,1 and standard error of measurement SEM value for the main investigator was 0. At the time of the leg-length measurements, all subjects completed a questionnaire on baseline characteristics, which asked them to report their sex, age, height and weight. Prior to the season, the research team educated the runners to report any RRI symptoms to their coach.

Additionally, each coach was trained in how to recognize common RRI symptoms among their runners and how to properly record them in the daily injury report DIR form. In addition, the mobility test of Ott for the thoracic spine and the technique of Schober for mobility of the lumbar spine should be carried out in anteflexion and retroflexion.

Hoppenfeld - Physical Examination of the Spine and Extremities

Figure 4 Testing for cranial movement of the spinae iliacae posteriores superiores. The second part of the functional diagnostic examination should be carried out if possible on a couch which can be approached by the examiner from all sides.

The patient is supine. This part of the functional diagnostic examination begins with the isometric testing of resisted movement of the long extensor muscle of the great toe on both sides, a muscle supplied from segment L5. The isometric eversion test of the foot tests the muscles of the peroneus group which are supplied from segment S1.


Mainly the anterior tibial muscle is tested by the inversion test as evidence of disorders in Segment L4. Absence or marked weakening of the Achilles tendon reflex suggests a disorder in Segment S1.

The same symptoms for the patellar tendon reflex are evidence of a disorder in Segment L4. In addition, the Bragard test for nerve root irritation is carried out. From this position of examiner and patient the flexion test of the hip joint can readily be carried out.

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The test for hip joint extension can be omitted because it would require turning the patient into the prone position and because it contributes little towards the recognition of the capsular pattern of the hip joint [ 14 ]. The subsequent test of medial rotation is the most important test for disorders of the hip joint.

Abnormalities of lateral rotation are more indicative of periarticular problems.

Both tests are finished at the end of the range of movement with a slight, gentle springing back movement. The subsequent hyperabduction test of Patrick sign of four [ 15 ] yields information about the ipsilateral hip joint and sacroiliac joint if the opposite side of the pelvis is held still and information about the facet joints of the spine if no pressure is put on the pelvis [ 12 , 16 ].

These tests too are finished with a slight springing back movement. Finally an adduction test of the hip joint is carried out as additional information about the sacroiliac joint and sensitivity tests on the various dermatomes for additional differentiation between radicular and pseudoradicular symptoms.

Confirmatory tests complete and extend the functional diagnostic examination: In the supine long sitting test the patient is asked to sit up from a lying position and to indicate where pain from the back radiates into the leg.

The results of the long sitting test should, for example, correspond with those from the flexion test. In the reclination test the patient sits with the backs of his knees against the end of the couch.Additionally, each coach was trained in how to recognize common RRI symptoms among their runners and how to properly record them in the daily injury report DIR form.

Korean J Dance ;46 1 — The spine X-ray Fig.

In addition, severe hyperostosis was diffusely formed around bilateral hip joints. HLA-B27 was negative.

Stanley Hoppenfeld Clinical Examination Pdf

Case report A year-old man presented with a year history of slowly progressive, restricted bilateral hip joint motion. Lee HH. In: Measurement and evaluation in human performance.

J Athl Train ;36 1 —

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