Vertebral Artery Test (VBI): Screening for Vascular Issues

The Vertebral Artery Test (often called the VBI Test) is a crucial screening tool used by physiotherapists to check for Vertebrobasilar Insufficiency before performing cervical manipulations or mobilizations.

1. Purpose

The primary purpose of the Vertebral Artery Test (also known as the Cervical Quadrant Test or VBI Test) is to **screen for** Vertebrobasilar Insufficiency (VBI). It assesses the patency of the vertebral arteries and blood supply to the brainstem before performing manual therapy on the cervical spine.

2. How to Perform

1. The patient is positioned in supine (lying on their back) with their head extending off the end of the table.
2. The examiner supports the patient's head with both hands.
3. The examiner slowly extends the patient's neck, then rotates it to one side. (Some variations also add lateral flexion).
4. This position is held for 30 seconds while the examiner talks to the patient (to check speech) and monitors their eyes (pupils and nystagmus).
5. The test is repeated on the other side.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test is indicated by the appearance of the "5 D's" or "3 N's":

• Dizziness
• Diplopia (double vision)
• Drop attacks (sudden fainting)
• Dysphagia (difficulty swallowing)
• Dysarthria (difficulty speaking)
• Nausea
• Numbness (facial or body)
• Nystagmus (involuntary eye movement)

Negative Sign (Test is NEGATIVE):
A negative test is the absence of these symptoms after holding the position.