A Portable Wireless Solution for Back Pain Telemonitoring: A 3D-Based, Virtual Reality Approach - Computational Intelligence in Healthcare: Advanced Methodologies - page 426

1. Physiological tests
-Cervical ROM (Range Of Motion). With this test the clinician measures the
patient's active, extension, ventral/lateral flexion and rotation of the torso.
-Shoulder tests. Similarly, the shoulder muscles' strength and tension are
measured by the clinician asking the patient to exert force bilaterally while
having hands on the patient's arms, in one of specific eight directions at the
time: lower arm up/down, external/internal rotation, upper-arm abduction,
flexion, extension, and adduction.
-Tenderness. Using this test the clinician measures tenderness by exerting
mild to moderate pressure on 20 different areas, including spine, joints,
torso, arms, and shoulders.
-Hypotrophy. Additionally, hypotrophy is assessed in 8 areas including chin,
neck, neck-shoulder, shoulder, upper-arms, lower-arms, hands, and chest.
As part of the physical examination, the clinician should also perform a thorough
neurologic examination to assess muscle reflexes, sensation, strength, and stretch,
enabling him or her in that way to determine whether a dermatomal or myotomal
pattern is present. Assessing a patient based on neurological tests as well, is useful in
managing pain by helping identify factors other than anatomic that could affect the
condition [39]. Thus, [4] similarly to physiological tests highlighted above, they cite
in their work the following neurological examination:
2. Neurological tests
- Sensibility to pain. Pain sensation is measured from this test, in 10 indicator
areas for dermatomes by pressure exerted on these areas using two pin-
wheels.
- Strength. Muscle strength is tested in 7 movements by asking a patient to
resist force from the clinician's hand in the following movements (represent-
ing myotomes): head flexion/lateral flexion, shoulder elevation, arm abduc-
tion, elbow flexion/extension, and little finger hook.
- Reflexes. Similarly, reflexes are tested in the following 5 muscle groups:
suprapinatus, biceps, brachioradialis, triceps, and the Babinski reflex.
- Nerve stretch. Testing of the nerve stretching is also performed for the me-
dian, radial, and ulnar nerves.
-Neck compression/traction. The neck is accordingly tested for compression
and traction by again the clinician having the hands on top of the patient's
head and exerting increased pressure.
-Straight leg-raising test. Finally, using this test the clinician evaluates the
lower back and thigh muscle activation.