When we perform a test on a patient, whether it be something physical such as a straight leg raise or tissue palpation, a questionnaire or a blood pressure test, of course we think that we are testing the patient.
Rarely do we ever pause to think that the patient is actually testing the tester- in essence our test performance. What the patient offers back in the test response will be dependent on your handling, looks, words, context, timing, place of testing, previous test experiences, what they feel they need to offer – the list is a long one.
Most tests attempt to assess one specific output system of the body – for example, motor responses, pain, cortisol levels, inflammation etc. but this is impossible – many systems will combine to construct a response to any test.
It can be a bit disheartening and can make you wonder what you are testing sometimes (and why so many hours were put in to “perfecting” a technique). But there is no need to despair or throw all of the tests out. Every test will be a collision* between nervous systems – yours and the patient’s, but they don’t have to be violent and when used with updated clinical reasoning, powered up by modern neurobiology and framed within a biopsychosocial context every test can be a powerful interaction that will provide mountains of information about both the patient and you.
Noun: Physics. the meeting of particles or of bodies in which each exerts a force upon the other, causing the exchange of energy or momentum