Teste KEMP Ir para: navegação, pesquisa

Introduction

 Kemp’s test is a test to assess the lumbar spine facet joints. It is a provocative test to detect pain, which can be local, referred or radiculair.^[1]

Clinical Anatomy

The facet joints (FJ) or zygapophyseal joints play an important role in load transmission. The purpose of these FJ is to stabilize the motion segment in flexion, extension and also restricting axial rotation. They also provide a posterior load-bearing helper.
The lumbar FJ are paired, true synovial joint that comprise the posterolateral articulation between vertebral levels. The orientation of the FJ in a transverse plane varies from the upper level of the lumbar spine to the lower one.
Lumbar FJ contain hyaline cartilage, synovial membrane, fibrous capsule, and a joint space with a potential capacity of 1 to 2 mL. The existence of menisci in the lumbar FJ has been emphasized in numerous publications.^[2]

The purpose of this test is to assess the lumbar spine facet joints. Kemp test uses the patient’s trunk both as a lever to induce tension and as a compressive force. This test is used in differentiation and diagnosis of a lumbar posterior facet syndrome, though it is nonspecific.The kemp test is a provocation test to detect pain. Local pain suggest a facet cause, while radiating pain into the leg is more suggestive of nerve root irritation. Especially if the pain is below the knee.

Technique

It can be performed both while standing and sitting position.

References

1. ↑ Steve Jensen; back pain – clinical assessment; Australian Family Physician Vol. 33, No. 6, June 2004 (level of evidence:D)
2. ↑ Leonid Kalichman, BPT, PhD, and David J. Hunter, MBBS, Phd; Lumbar facet joint osteoarthritis: A review; 2007; Elsevier Inc; Semin Arthritis Rheum 37:69-80
3. ↑ Craig E. Morris; Low back syndromes; McGraw-hill professional; 2005 (Level of evidence: D)
4. ↑ Thomas A. Souza; differential diagnosis and management for the chiropractor; Jones & Bartlett Learning; 2008 (Level of evidence: D)
5. ↑ Mark A Lyle, Sarah Manes, Michael McGuinness, Sarah fckLRZiaei and Maura D Iversen; Relationship of Physical Examination Findings and Self-Reported Symptom Severity and Physical Function in Patients With Degenerative Lumbar Conditions; PHYS THER. 2005; 85:120-133. (level of evidence: A)