Position of the therapist:
- Standing at the long edge of the bench on the contralateral to be examined/treated
Position of the patient:
- Upright sitting position at the short edge of the bench
- Patient’s shoulder a little lower as the therapist’s shoulder
- Patient crosses arms in front of the chest
Hand placement:
- Establish contact with the patient’s back on the contralateral side by moving the arm between the patient’s crossed arms
- Fixating hand on L3 with a pinch grip in ventrocranial direction
- Patient brought slightly forward by flexing at the hip maintaining an upright trunk
Movement:
- Maximal homonymous 3D movement with equal components of extension, ipsilateral lateral flexion and ipsilateral rotation
- To test each component of intervertebral motion, slightly move out of the end-range and now test extension between L2 and L3 by pushing the spinous process of L3 ventrocranially
- To assess the rotation component, move to the ipsilateral arch of L3 and push it ventrally
- For the lateral flexion component, put the thumb between the spinous processes of L2 and L3 and perform lateral flexion with the upper hand
N.B:
Assessment of L5-S1 is not possible in sitting position as this segment is already relatively opened in this position