Active Straight Leg Raise Test

Indication: The active straight leg raise test (ASLR) is used to evaluate the possible role of pelvic ring instability.

Test Procedure: The ASLR test is performed in a supine position with straight legs and feet 20 cm apart. The test is performed after the instruction: “Try to raise your legs, one after the other, above the couch for 20 cm without bending the knee.” If positive, the test is repeated while the clinician provides manual compression of the innominates just lateral and posterior to the ASIS's. The pain and weakness should subside after this maneuver and the patient's abilityto perform the test should improve.

  • The patient is asked to score impairment on a six-point scale: not difficult at all = 0; minimally difficult = 1; somewhat difficult = 2; fairly difficult = 3; very difficult = 4; unable to do = 5. The scores of both sides were added, so that the summed score ranged from 0-10.
  • OR, the test can be considered positive when the patient feels weakness or pain that limits the ability to adequately complete the maneuver.

Evidence

Reliability

  • Mens, 2001
    • When measured one week apart:
      • Test-restest reliability: Pearson's correlation coeffcient = 0.87
      • ICC= 0.83 (Mens 2001)
    • Between the scores of the patient and scores of a blinded assessor
      • Pearson's correlation coefficient=0.78
      • ICC=0.77
  • Roussel, 2007
    • test-retest kappa= greater than .70
    • Cronbach alpha coefficient for internal consistency of the Trendelenburg and ASLR tests was greater than .73

Validity

  • Correlation between the scores on the active straight leg raise test and the Québec Back Pain Disability Scale was 0.70. No association was found between the active straight leg raise score and age, parity, duration of the postpartum period, height, or weight. (Mens 2002)
  • The best balance between specificity and sensitivity was found when scores 1-10 are designated as positive and zero as negative. With this cut-off point sensitivity of the test was 0.87 and specificity was 0.94. (Mens 2001)
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