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Low Back and Sacroiliac Joints
□ Sit to Stand Single Leg Rise
□ Gait:
level, heel, toe, tandem
□ Functional range of motion: flexion (finger-to-floor), extension, lateral flexion, rotation
□ Palpation:
spinous processes, paraspinal muscles, sacroiliac joints
□ Manual muscle testing:
Pronehip extension; knee flexion, extension;
Sidehip abduction, adduction;
Supinehip flexion; ankle dorsiflexion, plantarflexion, inversion, eversion; great
toe extension
□ Sensation:
medial and lateral thighs, medial and lateral ankles, first and fifth toes,
back of the knee
□ Muscle Stretch Reflexes: Knee, Ankle; Babinski reflex
□ Straight leg raise test
□ Patrick's test (F AB ER E)
□ Gaenslen’s test
□ Mystery test
Date 1 _______________
Date 2 _______________
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