Global motion tests serve to make the bodily regions with the most obvious limitations of movement stand out. In the trunk bend and sidebend (Fig. 10.1), we look for harmonious execution of movement. Interruptions or evasive movements are then examined in greater detail.
This area is examined with segmental tests and palpation for muscular or segmental restrictions. Based on differential tests, we finally attempt to find out whether it is the visceral, cranial, or parietal aspect of the problem that dominates in this patient. The part of the area that has been evaluated as dominant based on the findings is then treated specifically with adequate techniques.
We would now like to introduce a slightly different, but very rational type of examination. It is based on the Zink patterns and a traction test at the head, pelvis, and legs.
After quickly observing the patient's posture in stance and registering rough deviations, we have the patient bend forward and perform the hip-drop test or a translation test at the pelvis. This gives clues about the position and mobility of the sacrum and lumbar spinal column, as well as potentially about a dominant muscle chain.
Fig. 10.3a, b Rotation test of the hip in side comparison.
If we find conspicuous features in the lower extremities. we have the patient do a single-leg stance. Here, we observe the behavior of pelvis, knees, and feet. Neuromuscular disturbances in the leg muscles manifest in postural asymmetries due to muscular imbalances and the different behavior of the receptors as a result of segmental "facilitation."
The flexion test (Fig. 10.2) can give clues about a dominant chain on the leg and in the spinal column. The hip-drop test and the translation test give information about the position of the sacrum and the lower LSC.
In the supine position, we observe the rotation of the hips (Fig. 10.3), legs, pelvis (Fig. 10.4), and the lower (Fig. 10.5) and upper (Fig. 10.6) thoracic apertures (LTA and UTA), before testing the Zink patterns. Afterwards, a traction test is performed at the head and pelvis (or in the legs) to allow us to find the dominant side. In addition, this test helps in localizing the primary restriction and in differentiating between ascending or descending chains.
The earlier resistance occurs in traction, the closer we know the dominant motion limitation in the traction hand to be.'37-148
Fig. 10.6a, b Rotation test: (a) for the upper thoracic aperture (b) variation.
In the Zink patterns, we not only test the torsions in the junctions to find out where they do not alternate, but also mainly attempt to detect the junction at which the rotation pattern manifests most obviously, that is, where the rightward rotation (Fig. 10.12) distinguishes itself most clearly from the leftward rotation. Subsequently, we differentiate whether these are dorsal or ventral muscles that form the torsion pattern.
Each junction represents a certain body region. We have presented this in the previous chapters. There are anatomical (muscles) as well as neurological interconnections that illustrate this (Figs. 10.7-10.11). Here, we provide another quick summary:
• Suboccipital muscles
Upper Thoracic Aperture
• Sibson fascia
Lower Thoracic Aperture
• Diaphragm, abdominal muscles, and ribs VI—XII
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