ArticleBMC musculoskeletal disorders2021
Extending the straight leg raise test for improved clinical evaluation of sciatica: reliability of hip internal rotation or ankle dorsiflexion.
Article in BMC musculoskeletal disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 43 citations in OpenAlex.
- Multimodal Physical Therapy Management of Dysmenorrhea With Coexisting Mechanical Low Back Pain and Early Degenerative Lumbar Spondylosis: A Case Report.Clinical case reports · 2026Article
- Mechanosensitivity during straight leg raise and slump neurodynamic tests in people with type 1 diabetes mellitus and diabetic peripheral neuropathy.The Journal of manual & manipulative therapy · 2026Article
- Straight leg raise versus knee extension angle: which structure limits the test in asymptomatic subjects?The Journal of manual & manipulative therapy · 2025Article
- Hamstring Myometric Properties and the Functional Outcome in Young Adults with Radicular Pain: A Cross-Sectional Study.Journal of human kinetics · 2025Article
- A nerve root decompression position identified by 3D CT scan: the modified reversed contralateral axial rotation position for patients with lumbar disc prolapse.Journal of orthopaedic surgery and research · 2025Article
- Accuracy of the Standard and Distal-to-Proximal Sequence of the Upper Limb Neurodynamic Test 1 for the Diagnosis of Carpal Tunnel Syndrome: The Role of Side-to-Side Comparisons.Journal of clinical medicine · 2024Article
- An Eight-Week Randomized Controlled Trial of Active Mobilization of the Hamstrings for Non-Specific Low Back Pain and Musculoskeletal Discomfort during Prolonged Sitting among Young People: Study Protocol.Journal of clinical medicine · 2024Article
- Comparing the Scores of The Functional Movement Screen™ in Individuals with Low Back Pain versus Healthy Individuals: A Systematic Review and Meta-Analysis.International journal of sports physical therapy · 2024Article
- Comparison of magnetic resonance imaging findings among sciatica patients classified as centralizers or non-centralizers.The Journal of manual & manipulative therapy · 2023Article
- Short-Term Effects of Three Types of Hamstring Stretching on Length, Neurodynamic Response, and Perceived Sense of Effort-A Randomised Cross-Over Trial.Life (Basel, Switzerland) · 2022Article
- Hypoalgesic and Motor Effects of Neural Mobilisation versus Soft-Tissue Interventions in Experimental Craniofacial Hyperalgesia: A Single-Blinded Randomised Controlled Trial.Journal of clinical medicine · 2021Article
- Extending the straight leg raise test for improved clinical evaluation of sciatica: validity and diagnostic performance with reference to the magnetic resonance imaging.BMC musculoskeletal disorders · 2021Article
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe straight leg raise (SLR) is the most commonly applied physical tests on patients with sciatica, but the sensitivity and specificity ratings for disc hernia and neural compression leave areas for improvement. Hip internal rotation tensions the lumbosacral nerve roots and ankle dorsiflexion tensions the sciatic nerve along its course. We added these movements to the SLR (extended SLR = ESLR) as structural differentiators and tested inter-rater reliability in patients with LBP, with and without sciatica.
methodsForty subjects were recruited to the study by the study controller (SC), 20 in the sciatic group and in the control group. Two independent examiners (E1&E2) performed the ESLR and did not communicate to the subjects other than needed to determine the outcome of the ESLR. First, SLR was performed traditionally until first responses were evoked. At this hip flexion angle, a location-specific structural differentiation was performed to confirm whether the emerged responses were of neural origin. Cohen's Kappa score (CK) for interrater reliability was calculated for ESLR result in detection of sciatic patients. Also, the examiners' ESLR results were compared to the traditional SLR results.
resultsThe interrater agreement between Examiner 1 and Examiner 2 for the ESLR was 0.85 (p < 0.001, 95%CI: 0.71-0.99) translating to almost perfect agreement as measured by Cohen's Kappa When the ESLR was compared to the traditional SLR, the overall agreement rate was 75% (30/40). Kappa values between the traditional SLR and the E1's or E2's ESLR results were 0.50 (p < 0.0001; 95%CI 0.27-0.73) and 0.54 (p < 0.0001; 95%CI 0.30-0.77), respectively.
conclusionsESLR with the addition of location-specific structural differentiation is a reliable and repeatable tool in discerning neural symptoms from musculoskeletal in patients with radiating low back pain. We recommend adding these movements to the standard SLR with aim of improving diagnostic ability.
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