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Thessaly's Test
Thessaly's Test is a useful tool for determining the effectiveness of a website's navigation and user interface. The test helps inform designers and developers of ways to improve the user experience of a website, with analysis of key UI elements that affect website navigation and functionality. It provides an overall score, as well as detailed performance metrics for every aspect of the website's user experience.
Transcript
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This is Brent of the Brookbush
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Institute and in this video we're going to
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go over the Thessaly's test which might be our most sensitive test for
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meniscus tears. I'm going to have my friend Yvette come out, she's going to help me
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demonstrate. Now we'll say Yvette came in with some knee pain, we want to check out
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to see if her meniscus is in good shape. I know this is a sensitive test so a
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good initial screen, because if we get a negative on this test we're potentially
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in good shape. What I'm going to have you do now Yvette is you're going to stand on one
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leg, now I want you to go down and do a little mini squat for me. So we want
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about twenty-degrees of knee flexion. I'm going to go ahead and let her hold my hands
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because the next thing I'm going to have her do would be very hard to maintain balance,
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but she's going to turn all the way to her right on that leg and all the way to her
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left on that leg. She's going to do this three times in each direction for me. Now
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a positive for this test would be pain or replication of her concordant sign,
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all right being the symptom she came in with. Or if she feels any popping or
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locking or like her knee wants to give, any of that? Nothing. So that was
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all negative, go ahead and relax. Now this test has been
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investigated at five-degrees of knee flexion and zero-degrees of knee flexion,
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which I think it actually might have a different name at zero-degrees, something
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called like the Merck sign, but for whatever reason the the test seems to
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lose sensitivity when we decrease the knee angle below 20-degrees. So keep that
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in mind, make sure somebody gets into a little bit of a squat. My guess is that
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when you get into that little bit of squat we are increasing the amount of
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compression and pressure on the meniscus which would increase the sensitivity of
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this test. Now we do have to keep in mind that in general we kind of suck at
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diagnosing meniscus tears, this is an unfortunate fact. Even though this
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is a more sensitive test there is reason to question some of the research, I did
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mention in the McMurray's test video that I would pair these two tests.
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So I'm going to use this test because it looks like it might
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be the highest sensitivity test, and then the McMurray's test tends to be our most
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specific test. We also have the advantage of McMurray's test being far more
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researched with better research. The two of these combined hopefully help
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increase our diagnostic accuracy a little bit, but I don't have a research
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cluster test to confirm that for you. How I would personally use these is
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I would go okay let's do Thessaly's test again, so let's review maybe we'll do your other
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leg, Alright so go ahead and stand on your affected leg, so the one that
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your came in complaining about, we're going to go ahead and mini squat down to 20-
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degrees, you're going to turn all the way to your right, all the way to your left, you
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can add some joke about dancing in here just to make your
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clients happy. Does that replicate any of your symptoms? (No). Any
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clicking or popping? If we get a negative in this test that's what I'm
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going to weigh more heavily, if I got a positive on this test I probably would
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not weigh it as heavily as the negative. I would then follow this up with
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McMurray's test, and if I did get a positive on this test and then a positive on
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McMurray's too now I'm thinking okay there is a chance of meniscus tear. Of
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course that's probably going to lead me right back into at least trying a few
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sessions of physical therapy, before I would ask for more diagnostic testing
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from perhaps a referral to the physician. So that's it, that's the
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Thessaly's test, 20-degrees of knee flexion. You're just rotating on one leg in a
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semi-squat position. We know that sensitivity decreases with a less knee
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angle, so if for some reason you did have to do this with less knee the angle just
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keep that in mind, and hopefully we get some more research on this particular
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test which seems to have a high likelihood that it could be a really
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good test, we just need some better research. If you have any questions
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