Table 1 OSPE Checklist

Rater #

Item

1. Cervical Spinal

Correct

Incorrect

a) Three-Step-Diagnosis

1

Examiner faces the patient

2

Locates point of irritation (IP) (one finger’s breadth lateral of the spinous process)

3

Consults the patient for pain

Segmental hypomobility

4

Palpates the spinous processes C4-C6

5

Checks cervical rotation

6

Checks cervical flexion

Response of the IP to movement

7

Palpates IP

8

Checks cervical rotation

9

Consults the patient for increase/decrease in pain intensity and change in consistency of the IP during movement

b) Rotation-traction-technique

Positioning of the patient

10

Upright position, adequate seat height

11

Examiner stands beside the patient

Hand placement

12

Proximal phalanx of the thumb level to zygoma

13

Forefinger yoke

14

Other hand immobilizes inferior border of vertebral arch

15

15°-degree tilt of the head to farside of the examiner

16

15°-degree rotation to uninvolved side

17

Builds up pre-tension (traction/rotation)

Test traction

18

Further rotation of the neck

19

Consults the patient for increase in pain intensity, other symptoms, dizziness

20

Returns to pre-tension

Manipulation

21

Rotational impulse to uninvolved side

22

Manipulation in expiration

2. Thoracic spine

Correct

Incorrect

a) Three-Step-Diagnosis

23

Patient is in prone position

24

Locates point of irritation (IP) (one finger’s breadth lateral of the spinous process)

25

Consults the patient for pain

Segmental hypomobility

26

Palpates the spinous processes (three adjacent vertebrae)

27

Checks rotation (lifts arm)

28

Checks flexion

Response of the IP to movement

29

Palpates IP

30

Checks rotation (lifts arm)

31

Consults the patient for increase/decrease in pain intensity and change in consistency of the IP during movement

b) Cross-hand-technique

Positioning of the patient

32

Patient is in prone position

33

Positions him/herself on rotation-sensitive side

Hand placement

34

Places hypothenar eminence of left hand over posterior transverse process of dysfunctional segment

35

Fingers pointing cranially

36

Places hypothenar eminence of right hand over opposite side transverse process approximately one segment below dysfunctional segment

37

Fingers pointing laterally

38

Builds up pre-tension

Test traction

39

Puts more pressure on transverse process

40

Consults the patient for increase in pain intensity, other symptoms, dizziness

41

Returns to pre-tension

Manipulation

42

Rotational impulse to uninvolved side

43

Manipulation in expiration

3. Lumbar spine

Correct

Incorrect

a) Three-Step-Diagnosis

44

Locates point of irritation (IP) (one finger’s breadth lateral of the spinous process)

45

Consults the patient for pain

Segmental hypomobility

46

Palpates the spinous processes (three adjacent vertebrae)

47

Checks rotation

48

Checks flexion

Response of the IP to movement

49

Patient is in prone position

50

Palpates IP

51

Checks rotation (lifts pelvis/shoulder on one side)

52

Consults the patient for increase/decrease in pain intensity and change in consistency of the IP during movement

b) Counter-rotation manipulation

53

Patient lies on their side

54

Rotation-sensitive side up

55

Patient is positioned on the edge of the exam table

56

hip and knee of upper leg is flexed (90°)

57

Examiner’s thigh secures tibial head of the patient

58

Counter-rotation of the spine

Hand placement

59

Index and Ringfinger guide the Middlefinger

60

Places finger on the spinous process of the segment to be assessed

61

Places arm on Os ilium

62

Aligns arm with patient’s back (bridging)

63

Builds up pre-tension

Test traction

64

Applies traction

65

Consults the patient for increase in pain intensity, other symptoms, dizziness

66

Returns to pre-tension

Manipulation

67

Rotational impulse to uninvolved side

68

Manipulation in expiration

4. Sacroiliac joint

Correct

Incorrect

a) Three-Step-Diagnosis

69

Patient is in prone position

70

Locates point of irritation (IP)

71

three finger’s breadth lateral of the posterior superior iliac spine (PSIS)

72

four finger’s breadth caudal of the iliac crest

Segmental hypomobility

73

Patient stands upright

74

Examiner is positioned behind the patient

75

Places left thumb on left ASIS

76

Places right thumb on right ASIS

77

Asks patient to bend slowly forward

78

Monitors PSIS downward motion on affected side

Response of the IP to movement

79

Patient is in prone position

80

Examiner is positioned behind the patient

81

Palpates IP

82

Checks cranialisation

83

Checks caudalisation

84

Checks ventralisation

85

Checks dorsalisation

86

Consults the patient for increase/decrease in pain intensity and change in consistency of the IP during movement

b) Panther’s jump technique

87

Patient is in prone position

88

Patients’ legs hang over the edge of the table

89

Examiner is positioned at the foot of the table

Hand placement

90

Affected leg is fixed between examiner’s lower thighs

91

Uses ulnar edge of hand

92

Places hand from a caudal direction on the affected side of the sacrum

93

Places the other hand on top of the first

Builds up pre-tension

94

→ Applying traction by carefully moving backwards

95

→ Applying tangential force on the sacrum

Test traction

96

Applies traction

97

Consults the patient for increase in pain intensity, other symptoms, dizziness

98

Returns to pre-tension

Manipulation

99

Short thrust to uninvolved side

100

Manipulation in expiration