Is the Straight Leg Raise Suitable for the Diagnosis of Radiculopathy? Analysis of Diagnostic Accuracy in a Phase III Study
The straight leg raise test (SLR) has been proposed to detect increased nerve mechanosensitivity of the lower limbs in individuals with low back pain. However, its validity in the diagnosis of lumbosacral radiculopathy shows very variable results. The aim of this study was to analyse the diagnostic...
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MDPI AG
2023-12-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/11/24/3138 |
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| author | Alberto Montaner-Cuello Elena Bueno-Gracia Diego Rodríguez-Mena Elena Estébanez-de-Miguel Miguel Malo-Urriés Gianluca Ciuffreda Santos Caudevilla-Polo |
| author_facet | Alberto Montaner-Cuello Elena Bueno-Gracia Diego Rodríguez-Mena Elena Estébanez-de-Miguel Miguel Malo-Urriés Gianluca Ciuffreda Santos Caudevilla-Polo |
| author_sort | Alberto Montaner-Cuello |
| collection | DOAJ |
| description | The straight leg raise test (SLR) has been proposed to detect increased nerve mechanosensitivity of the lower limbs in individuals with low back pain. However, its validity in the diagnosis of lumbosacral radiculopathy shows very variable results. The aim of this study was to analyse the diagnostic validity of the SLR including well-defined diagnostic criteria (a change in symptoms with the structural differentiation manoeuvre and the reproduction of the patient’s symptoms during the test or the asymmetries in the range of motion or symptoms location between limbs) in a sample of participants in phase III with suspicion of lumbar radiculopathy using the electrodiagnostic studies (EDX) as the reference standard. A phase III diagnostic accuracy study was designed. In total, 142 individuals with suspected lumbosacral radiculopathy referred for EDX participated in the study. Each participant was tested with EDX and SLR. SLR was considered positive using three diagnostic criteria. The sensitivity of the SLR for Criterion 3 was 89.02% (CI 81.65–96.40), the specificity was 25.00% (CI 13.21–36.79), and the positive and negative likelihood ratios were 1.19 (CI 1.01–1.40) and 0.44 (0.21–0.94), respectively. SLR showed limited validity in the diagnosis of lumbosacral radiculopathy. The incorporation of more objective diagnostic criteria (asymmetry in range of motion or localisation of symptoms) improved the diagnostic validity but the imprecision of the confidence intervals limited the interpretation of the results. |
| first_indexed | 2024-03-08T20:43:58Z |
| format | Article |
| id | doaj.art-96e50f6dd91244509f3690adf2db1199 |
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| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-08T20:43:58Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-96e50f6dd91244509f3690adf2db11992023-12-22T14:11:55ZengMDPI AGHealthcare2227-90322023-12-011124313810.3390/healthcare11243138Is the Straight Leg Raise Suitable for the Diagnosis of Radiculopathy? Analysis of Diagnostic Accuracy in a Phase III StudyAlberto Montaner-Cuello0Elena Bueno-Gracia1Diego Rodríguez-Mena2Elena Estébanez-de-Miguel3Miguel Malo-Urriés4Gianluca Ciuffreda5Santos Caudevilla-Polo6Physiatry and Nursery Department, Health Sciences Faculty, University of Zaragoza, 50009 Zaragoza, SpainPhysiatry and Nursery Department, Health Sciences Faculty, University of Zaragoza, 50009 Zaragoza, SpainPhysiatry and Nursery Department, Health Sciences Faculty, University of Zaragoza, 50009 Zaragoza, SpainPhysiatry and Nursery Department, Health Sciences Faculty, University of Zaragoza, 50009 Zaragoza, SpainPhysiatry and Nursery Department, Health Sciences Faculty, University of Zaragoza, 50009 Zaragoza, SpainPhysiatry and Nursery Department, Health Sciences Faculty, University of Zaragoza, 50009 Zaragoza, SpainPhysiatry and Nursery Department, Health Sciences Faculty, University of Zaragoza, 50009 Zaragoza, SpainThe straight leg raise test (SLR) has been proposed to detect increased nerve mechanosensitivity of the lower limbs in individuals with low back pain. However, its validity in the diagnosis of lumbosacral radiculopathy shows very variable results. The aim of this study was to analyse the diagnostic validity of the SLR including well-defined diagnostic criteria (a change in symptoms with the structural differentiation manoeuvre and the reproduction of the patient’s symptoms during the test or the asymmetries in the range of motion or symptoms location between limbs) in a sample of participants in phase III with suspicion of lumbar radiculopathy using the electrodiagnostic studies (EDX) as the reference standard. A phase III diagnostic accuracy study was designed. In total, 142 individuals with suspected lumbosacral radiculopathy referred for EDX participated in the study. Each participant was tested with EDX and SLR. SLR was considered positive using three diagnostic criteria. The sensitivity of the SLR for Criterion 3 was 89.02% (CI 81.65–96.40), the specificity was 25.00% (CI 13.21–36.79), and the positive and negative likelihood ratios were 1.19 (CI 1.01–1.40) and 0.44 (0.21–0.94), respectively. SLR showed limited validity in the diagnosis of lumbosacral radiculopathy. The incorporation of more objective diagnostic criteria (asymmetry in range of motion or localisation of symptoms) improved the diagnostic validity but the imprecision of the confidence intervals limited the interpretation of the results.https://www.mdpi.com/2227-9032/11/24/3138diagnosismechanosensitivitylumbosacral radiculopathystraight leg raise |
| spellingShingle | Alberto Montaner-Cuello Elena Bueno-Gracia Diego Rodríguez-Mena Elena Estébanez-de-Miguel Miguel Malo-Urriés Gianluca Ciuffreda Santos Caudevilla-Polo Is the Straight Leg Raise Suitable for the Diagnosis of Radiculopathy? Analysis of Diagnostic Accuracy in a Phase III Study Healthcare diagnosis mechanosensitivity lumbosacral radiculopathy straight leg raise |
| title | Is the Straight Leg Raise Suitable for the Diagnosis of Radiculopathy? Analysis of Diagnostic Accuracy in a Phase III Study |
| title_full | Is the Straight Leg Raise Suitable for the Diagnosis of Radiculopathy? Analysis of Diagnostic Accuracy in a Phase III Study |
| title_fullStr | Is the Straight Leg Raise Suitable for the Diagnosis of Radiculopathy? Analysis of Diagnostic Accuracy in a Phase III Study |
| title_full_unstemmed | Is the Straight Leg Raise Suitable for the Diagnosis of Radiculopathy? Analysis of Diagnostic Accuracy in a Phase III Study |
| title_short | Is the Straight Leg Raise Suitable for the Diagnosis of Radiculopathy? Analysis of Diagnostic Accuracy in a Phase III Study |
| title_sort | is the straight leg raise suitable for the diagnosis of radiculopathy analysis of diagnostic accuracy in a phase iii study |
| topic | diagnosis mechanosensitivity lumbosacral radiculopathy straight leg raise |
| url | https://www.mdpi.com/2227-9032/11/24/3138 |
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