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The Slump Test is designed to detect tension in the neuromeningeal tract via the combined movements of the spine and lower extremity. This test is typically used for a suspected lumbar disc herniation causing radiculopathy but it can be used for suspected lesions throughout the spine.
This test is performed in several stages that involve placing the patient in a series of positions to gradually and progressively stretch the neural structures. At each stage of the test, stop, and ask the patient if there is a reproduction or exacerbation of their symptoms. If so, this would constitute a positive result and no further testing is required.
To begin the test, the patient sits on the examination table with the hands behind the back. Place one hand on the patient’s upper thoracic spine and the other under the patient’s chin.
Ask the patient to slump forward while you continue to support the patient’s chin to keep the neck in a neutral position. If no symptoms are experienced, remove your hand from the chin and ask the patient to bring the chin toward the chest.
If no symptoms are experienced, apply pressure over the upper back and head to help sustain the slumped position and ask the patient to extend the knee on the involved side. If no symptoms are experienced, assist the patient to perform ankle dorsiflexion. If the knee remains in its extended position and there is no reproduction or exacerbation of symptoms the Slump test is considered negative. On the other hand, if the patient is unable to maintain the knee extension and reports posterior thigh or leg pain it may be due to either neural or muscle tension.
To differentiate, release the pressure over the head and upper back and ask the patient to extend the neck. This reduces neuromeningeal traction. Ask the patient to reattempt full knee extension. If the patient is now able to increase knee extension, the Slump test is considered positive and suggests the presence of tension in the neuromeningeal tract. If the patient is still unable to increase knee extension, muscle tightness should be considered as the cause.
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