Inverted Supinator Test
Purpose[edit | edit source]
The inverted supinator (brachioradialis) test is used for identifying a lesion at the C5-C6 spinal cord segments. The inverted supinator reflex is a test that was introduced into clinical medicine by Babinski (1910). [1]
There are two components of this abnormal reflex:
- an absence of contraction of the brachioradialis muscle when the styloid process of the radius is tapped, and
- a hyperactive response of the finger flexor muscles; a response that is subserved by a lower spinal cord segment (C8).
Research explains lesion at C5-C6 cord levels impairing the segments directly is responsible for the brachioradialis reflex, and that the hyperactivity of the finger flexors was due to reflex irradiation to a lower level by a central mechanism (Babinski, 1910; Dejerine, 1926). Walshe (1963), while confirming the frequency of this reflex 'inversion' in
Technique[edit | edit source]
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Evidence[edit | edit source]
Research study aimed at producing a cluster of predictive clinical test findings for a sample of a patient using a clinical diagnosis as the reference standard for CSM found that selected combinations of clinical findings: (1) gait deviation; (2) +Hoffmann’s test; (3) inverted supinator sign (sensitivity 0.18; specificity:0.99; +LR 29.1;-LR:0.82); (4) +Babinski test; and (5) age >45 years were effective in ruling out and ruling in cervical spine myelopathy. Combinations of three of five or four of five tests enabled adjustments of post-test probability of the condition to 94–99% and these clusters may be useful in identifying patients with this complex diagnosis in similar patient populations.[2]
Resources[edit | edit source]
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References[edit | edit source]
- ↑ Estanol BV, Marin OS. Mechanism of the inverted supinator reflex. A clinical and neurophysiological study. Journal of Neurology, Neurosurgery & Psychiatry. 1976 Sep 1;39(9):905-8.
- ↑ Cook C, Brown C, Isaacs R, Roman M, Davis S, Richardson W. Clustered clinical findings for diagnosis of cervical spine myelopathy. Journal of Manual & Manipulative Therapy. 2010 Dec 1;18(4):175-80.
- ↑ Physiotutors Inverted Supinator Sign | Upper Motor Neuron Lesion. Available from https://www.youtube.com/watch?v=_H5Pv8istcI&vl=es. Accessed on 25/2/21
