Marine combat operations in Iraq, Kosovo and Somalia. However, on reflection, she commented, "I do feel like I could focus better."Ĭase #3: A 41-year-old unemployed man presented with complaints of neck, arm, and low back pain. The progress exam took place in the late morning. Her initial remark regarding the improvement was that her initial reading had been done in the evening, when she would have been a bit tired. When reverse digit span was retested, her score was 5. Two weeks after the second adjustment, a progress exam indicated improvement in symptoms and subluxation signs. An additional adjustment was administered two days later. Reverse digit span was 3.ĭiversified adjustments were administered for correction of subluxation, and reflex work was utilized for correction of ocular lock. There was also an inhibition of muscle function when gazing to the left (known as "ocular lock" in applied kinesiology). She also mentioned she had felt a "drop in concentration" over the previous six years.Ĭhiropractic examination revealed subluxation at the right SI, T9, T3, and C5. She had suffered multiple slip-and-fall injuries over the years, which she claimed caused "no injuries." She had been experiencing a great deal of distraction due to her care of a pair of elderly friends and her elderly parents. She stated that her grandson had "jumped on her neck" while she was bent over to pick something up six weeks prior to the visit. Post-adjustment, the patient demonstrated a reverse digit span of 6.Ĭase #2: A 59-year-old full-time homemaker presented for her initial visit with a complaint of neck and right shoulder pain. Following diversified adjustments for the subluxations and neurolymphatic stimulation for the muscle imbalances, the patient reported substantial relief. Prior to the adjustment, the patient demonstrated a reverse digit span of 3. The patient apologized for arriving late to the appointment, explaining he had been distracted that day. Manual muscle testing indicated inhibition of the right piriformis and gluteus maximus muscles. Subluxations of the right sacroiliac, 元, C7, C1, and left sternoclavicular joint were identified. These cases were selected to illustrate the usefulness of this simple test across a wide range of patient presentations.Ĭase #1: A 50-year-old male building contractor who attended care for periodic musculoskeletal problems complained of low back pain after playing golf. Case #4 involved a definite concussion in the acute stage. Case #3 illustrates probable post-concussion chronicity. Case #2 may have involved a mild concussion due to indirect transmission of mechanical trauma to the head. Applied kinesiology protocols were followed for challenge, manual muscle testing, and all reflex procedures. In the brief case summaries that follow, subluxations were identified by motion palpation and challenge. For an adult with average powers of attention, their reverse digit span should be 5 or greater. For example, if they succeed with the above series, but fail with a series of four, their reverse digit span is 3. The number of digits in the series prior to the patient's error is their reverse digit span. The examiner then speaks a series of four digits, then five, etc., increasing the number of digits spoken until the patient fails to repeat them in reverse order. For example, the examiner says, "Eight, four, seven," and the patient says, "Seven, four, eight." The digits are spoken in a monotone with equal spacing between each, not clumped together like a phone number. The examiner speaks a series of digits, asking the patient to repeat them in reverse order. 2 Case evidence suggests the reverse digit span test is a useful tool for assessing patients both with and without concussion symptoms, and tracking their improvement following chiropractic care. 1 It has been part of the armamentarium of cognitive assessment for many years. It is a component of the SCAT3 test, which is frequently used to assess concussion. Reverse digit span is an easily administered test of attention span.
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