ART Spinal & Core Assessment 2 — Questions and Answers
Question 1: During ART spinal assessment, which finding indicates a positive Kemp's test?
- Reproduction of radicular pain with lumbar extension and ipsilateral rotation (Correct answer)
- Relief of back pain upon lumbar flexion
- Increased grip strength with cervical distraction
- Bilateral hip flexor tightness
Correct answer: Reproduction of radicular pain with lumbar extension and ipsilateral rotation
Kemp's test is positive when lumbar extension combined with ipsilateral rotation reproduces radicular or local pain, implicating facet joint or foraminal compromise.
Question 2: In ART practice, the 'contact-tension-movement' principle applied to the multifidus requires the patient to perform which motion during tissue tension?
- Spinal flexion to lengthen the multifidus under the contact (Correct answer)
- Spinal extension to shorten the multifidus
- Lateral cervical flexion away from contact
- Anterior pelvic tilt only
Correct answer: Spinal flexion to lengthen the multifidus under the contact
ART protocol moves the muscle from shortened to lengthened position; for the multifidus, spinal flexion lengthens it while the practitioner maintains tension on the tissue.
Question 3: Which spinal landmark is palpated to locate the L4-L5 interspace during ART lumbar assessment?
- Iliac crest line (Tuffier's line) (Correct answer)
- Posterior superior iliac spine (PSIS)
- Greater trochanter level
- 12th rib inferior border
Correct answer: Iliac crest line (Tuffier's line)
Tuffier's line connecting the iliac crests typically corresponds to the L4-L5 interspace, serving as a reliable landmark for lumbar segmental assessment.
Question 4: An ART provider assesses core stability by observing the patient hold a dead-bug position. What constitutes a failed assessment?
- Lumbar spine extends off the table when the contralateral limbs are lowered (Correct answer)
- Slight knee flexion during leg lowering
- Mild hip external rotation during arm reach
- Breath holding for 3 seconds
Correct answer: Lumbar spine extends off the table when the contralateral limbs are lowered
Lumbar extension off the table indicates insufficient deep core stabilization (transversus abdominis and multifidus), which is the key failure criterion in the dead-bug assessment.
Question 5: Which nerve root level is implicated when ART assessment reveals weakness of the extensor hallucis longus (EHL)?
- L5 (Correct answer)
- L4
- S1
- L3
Correct answer: L5
The extensor hallucis longus is primarily innervated by the L5 nerve root, so EHL weakness during myotomal testing points to L5 compromise.
Question 6: During cervical ART assessment, upper cervical instability is screened before soft tissue work primarily because:
- Alar and transverse ligament laxity poses risk of cord compression during cervical manipulation (Correct answer)
- Upper cervical muscles have fewer adhesions than lower cervical muscles
- Cervical ROM is greater in the upper segments
- ART protocols are not effective above C3
Correct answer: Alar and transverse ligament laxity poses risk of cord compression during cervical manipulation
Ligamentous instability at the upper cervical spine (C1-C2) risks vertebral artery or spinal cord compromise, making pre-screening essential before any cervical ART intervention.
Question 7: In ART core assessment, the Sahrmann core stability test level 1 specifically evaluates the ability to maintain neutral lumbar spine while performing which action?
- Sliding one heel along the table to full knee extension (Correct answer)
- Performing a full sit-up from supine
- Holding a 45-degree trunk lean for 10 seconds
- Completing a single-leg squat to 60 degrees
Correct answer: Sliding one heel along the table to full knee extension
Sahrmann Level 1 requires the patient to slide one heel to full extension while maintaining neutral lumbar spine, testing deep stabilizer activation under minimal load.
ART Spinal & Core Assessment 2
During ART spinal assessment, which finding indicates a positive Kemp's test?