Straight Leg Raise/CSLR
Автор: BU PT623: MS III Spine Lab
Загружено: 2014-12-14
Просмотров: 14076
Straight Leg Raise Test/CSLR
Purpose of Test: The straight leg raise and crossed straight leg raise test are used to assess nerve root compression at the L4-S2 levels.
Step 1: 0:14 With the patient lying supine, zero out the inclinometer with it placed on the tibial tuberosity.
Step 2: 0:29 Ask the patient to inform you if they experience any symptoms, then SLOWLY lift their leg into hip flexion while maintaining full knee extension. If the patient’s symptoms increase, stop right there and measure the angle using the inclinometer.
The straight leg raise test is considered positive if concordant leg pain is produced between 30-70 degrees of hip flexion.
The specificity of the test is increased by the addition of sensitizers. If you have a positive test, add the following steps:
Step 3: 1:17 Lower the patient’s leg to the point where they are just out of pain.
Step 4: 1:29 Passively dorsiflex the patient’s ankle, and ask if this makes their pain better, worse, or the same.
Step 5: 1:42 Return the ankle to neutral and ask the patient to lift their head off of the table. Again, ask if this makes their pain better, worse or the same.
If the sensitizers make their pain worse with the leg held just out of pain, this indicates that the patient’s symptoms are coming from increased neural tension rather than muscle stretch, thus confirming your finding of a positive straight leg raise test.
Crossed Straight Leg Raise Test
When performing the straight leg raise test, always start with the asymptomatic leg. If the patient’s symptoms IN THE AFFECTED LEG are produced or increased with a contralateral straight leg raise, this is a positive crossed straight leg raise test, and is highly indicative of a herniated disc. You do not need to use the sensitizers on the unaffected leg to confirm a positive crossed straight leg raise test.
Straight Leg Raise - Sensitivity: 0.91, Specificity 0.26.
NEGATIVE test strongly rules OUT disc herniation.
Crossed Straight Leg Raise - Sensitivity: 0.29, Specificity 0.88.
POSITIVE test rules IN disc herniation.
Evidence:
Jefferson, 2008 18.1.3 pp. 25-27
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