Thoracolumbar spine ROM exam

D

diablo6

PEB Forum Regular Member
Howdy all,

Had my ROM exam today and now have questions about it. Here goes:

In reference to the flexion and extension portion, the DR did something that kind of gets my hackes up.

When asked to bend forward i went all the way fwd until it became painful and where the fusion generally stops me from bending forward any further. The DR then pushes down on my shoulder and pushes me fwd another inch or two.

Same happened for the extension fortion of the exam.

I have researched guidance on the Army PDES website and i havenot seen anything that tells an examiner to push you further in any direction. Before I cry foul on this- am looking for any input.

Anyone experience this?

Can anyone provide a link/reference to physicians guidance stating to do this?

I am at a loss. Is flexibility considered to the extent to which one can flex without pain (you know like a person without a back injury)? - or is it how far the doc can bend you?

Thx in advance for any help!
 
I can't point to any guidance that they are allowed to do this because they cannot. The Deluca case (I will post it shortly) tells them to subtract from your ROM for factors such as pain, incoordination, lack of endurance, etc.

Your examiner did not evaluate you correctly from what you have said.
 
1. When Jason posts the DeLuca case, I would suggest that everyone read it.

2. You will find examiners and board members citing DeLuca as though it was a mantra, yet few of them are actually familiar with its contents and holding.

3. I agree with Jason that your exam was not properly done and suggest that you carefully check to see whether any positive Waddell's signs were noted indicating that you were guarding or otherwise behaving in a manner not consistent with your injuries.

4. If the answer is "yes" re Waddell's signs, then you really should seek another ROM exam as most board members view this as failing the "liar, liar, pants on fire" test.

5. Note- Some physical therapists and ortho spine doctors like to get "hands on" without realizing what they are doing as they view it as assisting the patient.

6. Others do it because they are testing whether the patient is exaggerating his or her symptoms.

7. In any event, while this is not an uncommon occurrence, it is inappropriate to push the patient further by manually asssisting him or her in the exam.

v/r

Jack Gately
 
Thank you both for replying. I had researched these exams fairly thoroughly prior to the board here and as soon as the dr said how it was going to be done and then did it, I was like - what the hell?

Anyway, I have had one prior MEB exam (2008) and two VA ratings exams (2007, 2009) and none of those examiners pulled this. I will be "non-concur" with the NARSUM unles it comes back very favorable which I doubt.

I'll advise what happens- could be interesting.

thanks again!
 
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