Abstract
Introduction: Passive Straight Leg Raising Test (PSLRT) is one of the most commonly performed test in clinical practice. The purpose of this study was to survey the practice and interpretation of PSLRT amongst clinicians working in a tertiary care hospital.Methods: A 15 item questionnaire survey was developed covering various aspects of PSLRT. Orthopaedic surgeons(n=15), neurosurgeons (n=7) and physiotherapists (n=9)were identified as clinicians performing this test regularly and were approached to take part in the survey.Results: The PSLRT was used in all cases of back and leg pain by 68% and correctly performed by 30/31. There was a wide variation in the angle at which it was considered positive (median 45 degrees; range 10-90 degrees). Only 7/31 correctly recognised reproduction of leg pain as indicative of a positive PSLRT. The sitting /distraction SLRT andwell leg / cross SLRT was performed only by 3/31 and 16/31 of clinicians respectively. 90% felt that a positive PSLRT suggested nerve root irritation and 57% thought it was due to stretch of dura and / or nerve root. 23/31 clinicians felt that PSLRT was useful or very useful and 90% reported that result of PSLRT would affect the way they treat a patient.Conclusions: PSLRT is widely used, correctly performed and felt to be useful in practice. But the interpretation of a positive test, understanding of its mechanism and useof variations is poor. There is a need to improve the interpretation and understanding of PSLRT amongst its users.
Highlights
Passive Straight Leg Raising Test (PSLRT) is one of the most commonly performed test in clinical practice
Together with other clinical signs used in practice for evaluation of a patient with lumbar radiculopathy, it was found to be of limited utility when used in isolation 4, and with low reproducibility when used in general practice 6
Orthopaedic surgeons, neurosurgeons and physiotherapists working in a tertiary care hospital in Negara Brunei Darussalam were identified as practitioners who routinely use PSLRT in the assessment of patients with low back pain and radiculopathy
Summary
Passive Straight Leg Raising Test (PSLRT) is one of the most commonly performed test in clinical practice. The purpose of this study was to survey the practice and interpretation of PSLRT amongst clinicians working in a tertiary care hospital. Low back pain is a common reason for consulting a clinician and across the world it is a major cause for absence from work 1. Passive Straight Leg Raising Test (PSLRT) is one of the most common tests used in clinical practice .3-5. Together with other clinical signs used in practice for evaluation of a patient with lumbar radiculopathy, it was found to be of limited utility when used in isolation 4, and with low reproducibility when used in general practice 6. Rebain et al following a systematic review concluded that ‘there remains no standard PSLRT procedure, no consensus on interpretation of results and little recognition that a negative PSLRT outcome may be of greater diagnostic value than a positive one’ 7
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