ArticleBMC musculoskeletal disorders2021
Extending the straight leg raise test for improved clinical evaluation of sciatica: validity and diagnostic performance with reference to the magnetic resonance imaging.
Article in BMC musculoskeletal disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT05636917 (Study of the Diagnostic Accuracy of the Slump and Straight Leg Raise Neurodynamic Tests in Patients With Clinical Suspicion of Lumbar Radiculopathy), which is not on this map. Cited by 10 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Study of the Diagnostic Accuracy of the Slump and Straight Leg Raise Neurodynamic Tests in Patients With Clinical Suspicion of Lumbar Radiculopathy
Who cites it
10 citing papers in PubMed, 15 citations in OpenAlex.
- Acupuncture and Moxibustion Therapy Attenuates Inflammation in CCI-Induced Sciatica by Inhibiting the NF-κB Pathway.Journal of pharmacopuncture · 2026Article
- Hamstring Myometric Properties and the Functional Outcome in Young Adults with Radicular Pain: A Cross-Sectional Study.Journal of human kinetics · 2025Article
- Impact of Neurodynamic Sequencing on the Mechanical Behaviour of the Median Nerve and Brachial Plexus: An Ultrasound Shear Wave Elastography Study.Diagnostics (Basel, Switzerland) · 2024Article
- 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
- Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Clinical Suspicion of Lumbosacral Radiculopathy.Diagnostics (Basel, Switzerland) · 2024Article
- Article
- Is the Straight Leg Raise Suitable for the Diagnosis of Radiculopathy? Analysis of Diagnostic Accuracy in a Phase III Study.Healthcare (Basel, Switzerland) · 2023Article
- Therapists' experiences with implementing new documentation practices for low back pain in electronic health care records: an interview study.BMC research notes · 2023Article
- Correction to: 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 · 2022Article
- Correction to: 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
Corrections and comments
- Erratum issued
- Erratum issued
Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe straight leg raise test (SLR) is one of the most utilized and studied physical tests in patients with low back pain (LBP) for the detection of lumbar disc herniation (LDH), showing high sensitivity and heterogeneous or low specificity. The high incidence of asymptomatic 'pathologic' findings in the magnetic resonance imaging (MRI) scans may cause verification bias to these results. We studied an extended SLR (ESLR) by adding location-specific structural differentiation movements (hip internal rotation or ankle dorsiflexion) to the traditional SLR for it to better differentiate neural symptoms from musculoskeletal. Previously, the ESLR has shown almost perfect interrater reliability between examiners and ability to detect sciatic patients. In this study, we investigated whether a 'positive' ESLR finding is associated with pathology seen on MRI.
methodsForty subjects comprised the study population, 20 in sciatic group and 20 in control group. The ESLR was performed 'blinded' to the subjects. After the ESLR, each subject's lumbar MRI was evaluated. The MRIs were analyzed independently by 2 senior radiologists and a spine specialist clinician. The ESLR and MRI results were cross-tabulated. To obtain the odds ratio (OR) with positive ESLR or SLR results for LDH or nerve root compression (NC), a binary logistic regression analysis with subjects' age, gender, height and weight was performed. ESLR's validity was assessed by combination of interrater agreement and percentage prevalence of both LDH and NC.
resultsOf sciatic (ESLR+) patients, 85 % had LDH and 75 % NC in the MRI. Not surprisingly, MRI showed a very high incidence of 'false-positive' findings with the ESLR negative group. The ESLR showed 0.85 sensitivity and 0.45 specificity for LDH and 0.75 sensitivity and 0.50 specificity for NC. A positive result in the ESLR was found to be strongly associated with for both LDH and NC: the OR was 8.0 (p = 0.028) and 5.6 (p = 0.041), respectively.
conclusionsThe ESLR shows high validity in detecting neural symptoms and is strongly associated with pathology seen in the MRI when judged positive. We suggest the use of ESLR in clinical practice as a part of clinical examination, where it may prove to be a valuable tool in detecting patients with sciatic symptoms.
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