Description
The Kemp test (also known as the quadrant test and the extension-rotation test) is a provocative test that can be used to diagnose pain associated with facet joint pathology, such as osteoarthritis.
- Client performs joint extension and rotation of the spine (for the cervical or lumbar spine).
- The test is considered positive when a patient reports painful numbness or tingling in the relevant area. [1]
Purpose
The purpose of this test is to assess pain in the lumbar or cervical facet joints. It uses the patient’s torso as a lever and pressure to create tension. This test is used to identify and diagnose lumbar kyphosis syndrome, although it is nonspecific. [2] This is A provocative test that detects pain. Localized pain suggests a facet cause, while pain radiating to the leg/arm is more suggestive of nerve root irritation. Especially when the pain is below the knee/elbow. [3]
Technique
The Kemp test can be performed with the patient in a sitting or standing position.
Standing Position: 1. The patient stands in front of the therapist. 2. The therapist stabilizes the contralateral ilium on the side being tested with one hand. 3. Hold the patient’s shoulder with the other hand and guide the patient in ipsilateral lateral bending and rotation (3D stretching) move). 4. Hold this position for three seconds.
[4]
Sitting position: 1. Patient is seated with arms crossed over chest. 2. One hand of the clinician stabilizes the lumbosacral portion of the patient on the side being tested. 3. The other arm controls the patient’s upper body. 4. The patient is guided into flexion rotation lateral flexion and finally extension. 5. Depending on the patient’s response, axial compression may be used in the fully extended and flexed position to increase stress on the posterior joint.
The diagnosis is positive when the patient reports painful tingling or numbness in the lower back or lower extremities. The pain is on the side being tested.[5][6][2] Localized pain suggests a cause whereas radiating pain into the leg is more indicative of nerve root inflammation. Especially if the pain is below the knee.[3]A sitting posture is best because the therapist has more control over the patient’s position and the muscles are less overworked.[2][3]
[7]
The video below is a Kemp test in the cervical spine (similar to the Spurling Test).
[8]
Evidence
Kemp’s test is the most common method of diagnosing low back pain but it has an inconclusive sensitivity of 50-70%[6] and a specificity of 67.3%[9].
References
- ↑ Radiopedia Kemp Test Available:https://radiopaedia.org/articles/kemp-test?lang=gb (accessed 26.9.2022)
- ↑ Jump up to:2.0 2.1 2.2 Craig E. Morris; Low back syndromes; McGraw-hill professional; 2005 (Level of evidence: D)
- ↑ Jump up to:3.0 3.1 3.2 Souza TA. Differential diagnosis and management for the chiropractor: protocols and algorithms. Jones & Bartlett Publishers; 2009 Oct 7.
- ↑ Rocky Bains. Kemp’s Test. Available from: https://www.youtube.com/watch?v=tBVhHpxF3ZQ [last accessed 22/10/2020]
- ↑ Steve Jensen; back pain – clinical assessment; Australian Family Physician Vol. 33, No. 6, June 2004 (level of evidence:D)
- ↑ Jump up to:6.0 6.1 Lyle MA, Manes S, McGuinness M, Ziaei S, Iversen MD. Relationship of physical examination findings and self-reported symptom severity and physical function in patients with degenerative lumbar conditions. Physical therapy. 2005 Feb 1;85(2):120-33.
- ↑ Palmer Health Sciences Library. Kemp’s Test. Available from: https://www.youtube.com/watch?v=75bVhJ-sBcI [last accessed 22/10/2020]
- ↑ Massage nerd. Orthopedic Test – C / SPINE KEMP’S TEST. Available from: https://www.youtube.com/watch?v=jNdBq3eR-eY [last accessed 26.9.2022]
- ↑ Manchikanti L, Pampati V, Fellows B, Baha AG. The inability of the clinical picture to characterize pain from facet joints. Pain Physician. 2000 Apr;3(2):158-66.
