What should a therapist perform on a patient with severe cervical spasms after a fall from a horse?

• A. Cervical Distraction Test
• B. Sharp-Purser Test
• C. Upper Limb Tension Test
• D. Alar Ligament Test

Answer: (B)

In the context of a patient presenting with severe cervical spasms after a fall, the Sharp-Purser Test is especially relevant for assessing potential instability in the upper cervical spine, particularly at the level of the atlas and axis (C1-C2). This test is designed to identify any abnormal movements and possible subluxation of the atlantoaxial joint, which could indicate a serious injury or instability following trauma.

When a patient has experienced significant trauma, such as a fall, there is a heightened risk of injury in the cervical region, including the possibility of cord compression or damage due to misalignment or instability in the upper cervical joints. Conducting the Sharp-Purser Test helps the therapist determine whether to proceed with further examination or treatment or to refer for imaging studies to rule out serious conditions like fractures or ligamentous injuries.

The other tests, while useful for assessing various conditions, are not as directly beneficial in this acute situation involving possible instability. The Cervical Distraction Test primarily assesses the effects of traction on symptoms, the Upper Limb Tension Test evaluates tension in the upper limb neural structures, and the Alar Ligament Test is focused on assessing the integrity of the alar ligament but may not provide adequate information given the immediate concerns of instability