HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) All Versions of this Article: ptj.20060150v1 87/9/1233    most recent Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Cook, C. E Articles by Goode, A. Search for Related Content PubMed PubMed Citation Articles by Cook, C. E Articles by Goode, A. Social Bookmarking                      What's this?

A Pragmatic Neurological Screen for Patients With Suspected Cord Compressive Myelopathy

CE Cook, PT, PhD, MBA, OCS, FAAOMPT, is Assistant Professor, Department of Community and Family Medicine, and Director of Outcomes Measures, Department of Surgery, Center for Excellence in Surgical Outcomes, Duke University, Durham, NC 27710 (USA).
E Hegedus, PT, DPT, MS, OCS, is Assistant Professor, Department of Community and Family Medicine, Duke University.
R Pietrobon, MD, PhD, MBA, is Associate Professor, Department of Surgery, Center for Excellence in Surgical Outcomes, Duke University.
A Goode, PT, DPT, is Assistant Professor, Department of Community and Family Medicine, Duke University.

chad.cook{at}duke.edu

Physical therapists commonly use screening tests to identify upper motoneuron lesions such as cord compressive myelopathy (CCM), the presence of which necessitates appropriate medical referral. Signs and symptoms of CCM include sensory and ataxic changes of the lower extremities, poorly coordinated gait, weakness, tetraspasticity, clumsiness, spasticity, hyperreflexia, and primitive reflexes. Clinical tests and measures such as Hoffmann sign, clonus, Lhermitte sign, the grip and release test, the finger escape sign, the Babinski test, and the inverted supinator sign have historically been used as screens for CCM. For effectiveness as a screen, a clinical test or measure should demonstrate high sensitivity. Diagnostic accuracy studies have shown that clinical tests and measures for CCM often display low sensitivity, indicating that a negative finding may falsely suggest the absence of a condition or disease that actually is present. To counter the low levels of sensitivity, screening should include a combination of a thorough patient history, recognition of and appropriate referral for cauda equina symptoms, and clusters of any pertinent contributory tests and measures.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?