Execution
- 1Record the patient’s standard slump response first.
- 2Perform a proximal initiation sequence by adding spinal flexion before knee extension and ankle dorsiflexion.
- 3Perform a distal initiation sequence by positioning the ankle or knee first, then adding spinal flexion.
- 4Stop the sequence when familiar symptoms are reproduced.
- 5Remove one sensitizing component at a time to confirm whether symptoms are neurodynamic.
Positive outcome
The test is positive when the patient’s familiar symptoms are reproduced and altered by changing the order of distal and proximal loading. Symptom onset that changes substantially by sequence suggests that neural tissue mechanics are contributing. The result should be described by sequence rather than reduced to a single positive or negative label.
CommentMagee’s neurodynamic discussion supports the principle that the order of movement matters because neural tissue moves toward the joint where movement is initiated. This variant is a mechanistic clinical reasoning tool rather than a validated diagnostic-accuracy test. Use it to refine irritability and treatment direction, not to diagnose a structural lesion alone.
Low Clinical Value