Straight Leg Raise Test: Influence of Lumbosant© and Assistant Examiner in Hip, Pelvis Tilt and Lumbar Lordosis

Fernando Santonja-Medina,Sara Santonja-Renedo,Vicente Ferrer,Antonio Pastor,Pilar Andújar,Olga Rodríguez-Ferrán,Antonio Cejudo,Francisco Ayala,Mónica Collazo-Diéguez,Pilar Sainz De Baranda

doi:10.3390/sym12060927

Fernando Santonja-Medina, Sara Santonja-Renedo + Show 8 more

Open Access

https://doi.org/10.3390/sym12060927

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Abstract

The passive straight leg raise (PSLR) test is widely used to assess hamstring extensibility. However, to accurately measure hamstring extensibility throughout PSLR, appropriate stabilization of the pelvis must be provided in order to minimize the possible influence of any compensatory movement in the scores reached. The main purpose of this study was to demonstrate the degree of influence of the Lumbosant© and an assistant examiner in hamstring extensibility in healthy young adults. A secondary objective was to verify the variability of the posterior pelvic tilt movement. Hamstring muscle extensibility was measured using the traditional (only an examiner) and new (using a low-back protection support Lumbosant© and two trained [principal and assistant] examiners) PSLR procedures. Correlation coefficients were expressed using r values, accompanying descriptors and 90% confidence intervals. Variance explained was expressed via the R2 statistic. To examine possible differences, the Mann-Whitney U-test was conducted. Additionally, Cohen’s d was calculated for all results, and the magnitudes of the effect were interpreted and statistical significance set at p < 0.05. A stepwise multiple regression analysis was performed to examine the relationship between scores and values. The final score that was determined with the new PSLR is significantly lower (13° approximately) than the one obtained through the traditional procedure (75.3 ± 14.4° vs. 89.2 ± 20.8°; d = −0.777 [moderate]). The data presented in this study suggest that the PSLR may overestimate hamstring extensibility unless lumbopelvic movement is controlled. Therefore, we recommend the use of Lumbosant© and an auxiliary examiner to obtain more accurate hamstring extensibility scores.

Highlights

The assessment of hamstring extensibility is a common practice in both clinical and sport settings
Among the variables that were assessed in the study, the only significant difference detected between the groups was in body mass, height and body mass index (p ≤ 0.018), as well as the clinical measures of the traditional passive straight leg raise (PSLR) test (T_PSLR) and new PSLR test (N_PSLR)
Values expressed in degrees as mean ± standard deviation; traditional PSLR is performed (T_PSLR): traditional passive straight leg raise; new PSLR procedure (N_PSLR): new passive straight leg raise; LL: angle of lumbar lordosis; PT: angle of pelvic tilt; dvalue: values of effect sizes of Cohen in qualitative inference

Summary

Introduction

The assessment of hamstring extensibility is a common practice in both clinical and sport settings. In team sport athletes, an inadequate level of hamstring extensibility has been suggested as a primary risk factor for muscle strains [15,16,17], plantar fasciitis [18], knee injuries [19,20] and low-back disorders [21,22,23], such as spondylolysis [24,25] and disc herniation [26,27]. Radiography has been considered as the criterion measurement (gold standard) to assess hamstring extensibility due to its high level of accuracy and reliability [28,29]. It is widely accepted that the selection of a test should be based first on the criteria of high validity and reliability, and to value simplicity and universality of the procedure [37]

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