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Starter Content >> Body Regions >> Lumbar Spine & Hips >> Standing Lumbopelvic Flexion (SLPF)

STANDING LUMBOPELVIC FLEXION (SLPF)

Instruction and Performance: Demonstrate and verbalize the following for the patient.

 

Say:

Do:

Stand like this.

Feet parallel and hip width apart.

Bend forward like you are going to touch your toes.

Demonstrate forward flexion.

Go ahead, try that.

Patient does motion.

Good. Go down as far as you reasonably can. Hold that.

Patient holds end position.

1. Gross Range:
Measure distance of middle finger to the floor or note which knuckle is touching the floor. 
This is the gross range for SLPF. This is useful for measuring changes pre and post treatment. It also allows the provider to assess lumbar and hip motion in weight-bearing. Normal range consists of touching the floor with finger tips. However, normal is highly variable. It is helpful to ask: “Is this normal for you?” to determine if their range is limited compared with usual. For example, the patient may only be touching the floor when they can usually palm the floor.

Recording: record in notes as “SLPF2 inches from floor pretreatment” or “SLPF to proximal interphalangeal joint pretreatment.”
 

 

SLFP Gross Range Video

2. Quality: The motion should appear fast, smooth and effortless. Any deviation from this should be noted and interpreted. Example: an extremely slow, hesitant and guarded motion suggests disc pathology.


3. Symptoms: While the patient is holding the end position ask “What do you feel?” and follow up with “Point to it.” Note the location, quality and severity of symptom. Symptoms are helpful in determining pre and post treatment progress and in identifying dysfunctional tissue. Symptoms, like any data point, are not conclusive they just add to the body of data. Symptom Examples:

• Calf Tension = Think Sciatic Nerve
• Back Pain = Think Lumbar Problem (nonspecific)
• Posterior Thigh Tension or Pain
-Even and full range = stretch (normal)
-Even with limited range = protective tension
-Focal pain or tension = adhesion
-Painful Arc = possible disc (not adhesion)
• What produces symptoms? Load on sensitive tissue.
• Local Anatomy: What tissue are they pointing to?

SLPF is a nonspecific but extremely functional test. The ability to bend forward, touch the floor and return to an upright position is a prerequisite for a healthy low back and hips. If your patient can perform this test well a lot of tissues are working and healthy. If they can’t perform this test cross reference with the previous tests to determine the diagnosis and priority.

Patients intuitively understand that SLPF is something they should be able to do. Not being able to do this pain free is a very understandable and motivating deficit. When restricted tell the patient “You are 8 inches from the floor, you should be able to touch the floor. This needs to be fixed.”

Percent Function: Estimate using this guide: to knees 50%, mid shin 75%, touching floor 100%. When SLPF is the priority test (most restricted) disc pathology is responsible. There is no direct treatment for SLPF restriction. Dealing with disc pathology involves more advanced diagnostic and treatment procedures. See the Advanced Diagnosis section.