ABPTS OCS key terms

A systematic examination sequence that applies passive tension to each periarticular tissue in turn to distinguish contractile from noncontractile lesions. Findings of pain or limitation at a specific point in range localize the involved structure.

A characteristic proportional restriction of passive range of motion seen when the entire joint capsule is involved. Each joint has a recognized sequence, such as external rotation most limited at the glenohumeral joint.

The quality of resistance felt by the examiner at the limit of passive range of motion. Normal end-feels include bony, capsular, and soft tissue; abnormal examples include springy block, empty, and spasm.

Small accessory translations and rotations occurring between joint surfaces that cannot be produced voluntarily. Loss of joint play suggests hypomobility suitable for mobilization, whereas excessive play suggests instability.

The concept that restoring accessory joint motion improves osteokinematic motion and reduces pain. It underlies the use of grade I through IV mobilization techniques in manual therapy.

A five-level scale describing the amplitude of passive oscillatory joint mobilization within the available range. Grades I and II target pain, while grades III and IV target stiffness and range limitation.

A three-grade system describing sustained translational forces applied to a joint. Grade I neutralizes joint pressure, grade II takes up slack, and grade III stretches tissue, often combined with oscillation.

Sequences of joint positioning and sensitizing maneuvers that apply tension or sliding forces to a peripheral nerve bed. The test identifies mechanosensitivity of neural tissue when symptoms are reproduced and altered by distal or proximal movement.

A group of brachial plexus provocation sequences combining shoulder abduction, elbow extension, forearm supination, and wrist or neck movement. Reproduction of concordant symptoms suggests increased neural mechanosensitivity.

A passive test performed with the hip flexed and knee extended to tension the sciatic nerve tract. The angle of symptom onset and response to ankle dorsiflexion or neck flexion inform interpretation.

A seated test combining thoracic and cervical flexion, knee extension, and ankle dorsiflexion to apply tension along the neuraxis. Symptom alteration with cervical extension or ankle motion supports a neural component.

The ability of a test to correctly classify people with and without a condition, summarized by sensitivity, specificity, and likelihood ratios. It determines how much a test result should shift clinical probability.

The ratio of the probability of a given test result in people with a condition to that in people without it. Values farther from one produce larger shifts in post-test probability.

Sensitivity is the proportion of people with a condition who test positive; specificity is the proportion without the condition who test negative. Both are properties of the test rather than of the patient.

The number of patients who must receive an intervention for one additional favorable outcome compared with a control. It is the reciprocal of the absolute risk reduction.

The smallest change in an outcome measure that a patient perceives as beneficial. It complements statistical significance when judging whether an intervention produced meaningful improvement.

A range of values around an estimate that is likely to contain the true population value at a stated probability. Its width reflects precision and is influenced by sample size and variability.

A questionnaire completed by the patient that quantifies symptoms, function, or quality of life. Examples include the Disabilities of the Arm, Shoulder and Hand and the Oswestry Disability Index.

Amplification of neural signaling within the central nervous system that produces hypersensitivity to stimuli. It is characterized by hyperalgesia, allodynia, and spread of symptoms beyond the original injury site.

Pain elicited by a stimulus that does not normally provoke pain, such as light touch or gentle movement. Its presence suggests altered nociceptive processing rather than simple tissue damage.

An increased pain response to a stimulus that is normally painful. Primary hyperalgesia occurs at the injury site, while secondary hyperalgesia occurs in surrounding uninjured tissue.

A tendency to magnify the threat value of pain and feel helpless about it. High levels predict poorer outcomes and are measured with instruments such as the Pain Catastrophizing Scale.

A model explaining how pain interpreted as threatening leads to fear, avoidance, disuse, and worsening disability. Reducing fear through graded exposure is a core treatment implication.

Psychosocial risk factors that predict delayed recovery, including distress, fear of movement, and low expectations. They are distinct from red flags, which indicate serious medical pathology.

Clinical findings suggesting serious pathology such as fracture, infection, tumor, or cauda equina syndrome. Their presence warrants further medical evaluation or referral rather than continued conservative care.

A validated tool combining several examination findings to estimate the probability of a diagnosis or of responding to a treatment. It supports but does not replace clinical judgment.

A decision tool indicating radiography after ankle injury when there is bone tenderness at specified sites or inability to bear weight. It reduces unnecessary imaging with high sensitivity for fracture.

Provocative maneuvers for carpal tunnel syndrome. Phalen reproduces symptoms with sustained wrist flexion, and Tinel elicits tingling by tapping over the median nerve at the wrist.

Pelvic drop on the contralateral side during single-leg stance, indicating weakness of the hip abductors on the stance side. It is distinguished from a compensatory trunk lean.

Graded assessment of a muscle's ability to generate force against gravity and manual resistance. Grades range from zero, no contraction, to five, normal resistance through full range.

The motion occurring between articular surfaces, described as rolling, gliding, and spinning. Understanding these mechanics guides mobilization direction and joint-specific examination.

Visible rotation of bones about joint axes, described in cardinal planes as flexion, extension, abduction, and rotation. It is measured with goniometry or inclinometry.

Postoperative movement and loading restrictions intended to protect a replaced joint, such as posterior hip replacement precautions against combined flexion, adduction, and internal rotation.

An exercise in which the distal segment is free to move, isolating a muscle group and increasing shear forces at the joint. It contrasts with closed kinetic chain exercise, where the distal segment is fixed.

Application of a pneumatic cuff to a proximal limb to partially occlude venous return during low-load exercise. It builds strength with less joint stress and is used when heavy loading is contraindicated.

The process of disclosing the nature, risks, benefits, and alternatives of proposed care so the patient can decide voluntarily. It applies to examination, intervention, and participation in research.

The range of activities a clinician is legally and ethically permitted to perform based on licensure, training, and jurisdiction. It governs decisions about treatment and referral.

The ability of patients to consult a physical therapist without a physician referral, as permitted by state law. It carries responsibility for screening for conditions outside the therapist's scope.

Clinical decision making that integrates the best available research, clinician expertise, and patient values and preferences. No single element alone determines the plan of care.