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This is Brent of the Brookbush Institute and in this
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video we're going to do Spurling's
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compression test for cervical radiculopathy. I'm going to have my friend
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Yvette come out, she's going to help me demonstrate. Now we're going to assume that
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Yvette came in and she was complaining about some neck pain, and maybe she
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described some feelings that we're thinking might have something to do with
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some nerve irritation. So Yvette why don't you let me know are you having any
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symptoms right now? (No). All right which side were you having symptoms on? (Left). Okay so
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that's the first thing we want to do is make sure we have a good idea of what's
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going on in this position. So now she's having symptoms on her left side,
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we're going to see if we can make them worse by laterally flexing to the left
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side. So go ahead and start over again, notice she was actually very
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good, your patients are going to have a tendency to, go ahead and slouch for me,
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so like there you go, and then I'm going to go side bend, and you what would you do,
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just like this, and they like get that forward head side bend rotation combination. So
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make sure you are trying to be as reliable as possible in the sense that
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you're trying to define the test, make the test the same way every time. If you
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wanted to come back and reassess this particular test, you want to make sure
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that you know you don't test it in slouched position one time and then get
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all strict about form the next time, that's not going to help your reliability.
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So I'm going to make sure she's sitting up nice and tall,
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check her symptoms in this position, she's not having any but she says the
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history of her symptoms is on the left side. So I'm going to have her side bend to
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the left and does that bring on your symptoms? No so that doesn't bring on her
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symptoms. So far she's still negative but we have one more step and that's to
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side bend to the left and now I'm going to add overpressure. For those of
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you who know some stuff about joint exams and stuff you're very used
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to overpressure, I'm actually going to hold her this way so I can
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control her torso a little bit with my elbows, and I'm going to compress
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and laterally flex a little bit. So I'm pushing her head into this position
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while pushing straight down into compression, and if she still doesn't
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have symptoms, Yvette no symptoms? (No). Then this test is negative. If lateral
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flexion to the left or overpressure bring on her symptoms then this test is
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positive. So let's go over that one more time, sit up nice and tall. Check their
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symptoms, make sure that they're not currently having symptoms, laterally
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flex to the left, great. Once they've laterally flexed to the left did that make
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it worse? If that didn't it make it worse you're going to check with overpressure. Now
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how are we going to weigh this test, well this test is more specific than
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sensitive. In fact it's not particularly sensitive at all. So if I get a negative
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on this test it wouldn't rule out cervical radiculopathy just yet, I'm
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going to use a few more tests inside of a cluster to make sure that I am as
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accurate as I can be. If I have a positive on this test though I might start to
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seriously think cervical radiculopathy is a potential diagnosis, being that this
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test is specific a yes, a positive has far more weight. So there you have it,
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Spurling's compression test. We are going to add this to a cluster of tests which
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we'll talk about in a later video, this is more specific than sensitive. If you