Passive Lumbar Extension Test
Introduction
The Passive Lumbar Extension test (PLE test) came from Kasai et al. in 2006[1] as a way to determine lumbar spine instability. Originally, the common way to determine lumbar instability was through flexion-extension radiography, which the authors found mixed results and the definition of lumbar instability was too vague.
Technique
This test is performed as followed
- Have the patient laying in the prone position with the legs on the table
- Grasp both lower extremities (around the ankles will work) and elevate both lower extremities together to a height of 30 cm
- Make sure to keep the knees extended and apply a slight distraction force through the lower extremities
A positive is considered if pain is produced in the lumbar spine. In the study by Kasai, the subjects reported “low back pain, very heavy feeling on the low back, and feeling as if the low back was coming off.” The symptoms should be relieved when the legs are lowered back to the table.
Research
There is little in the terms of research on the PLE test. Kasai et al, did report a sensitivity of 84.2% and specificity of 90.4%[1]. The PLE was compared to the lumbar rocking test in terms of predicting lumbar instability. In the paper by Rathod et all, the PLE was found to be positive in 70% of the subjects (35 out of 50) and was found to have a sensitivity of 68.89% and a specificity of 20%[2]. The authors did state that it was a reliable test for lumbar instability, however, the sample size was relatively small (50) for this study.
References
- ↑ 1.0 1.1 Kasai, Y., Morishita, K., Kawakita, E., Kondo, T., & Uchida, A. (2006). A new evaluation method for lumbar spinal instability: passive lumbar extension test. Physical therapy, 86(12), 1661-1667.
- ↑ Rathod, A. K., Garg, B. K., & Sahetia, V. M. (2019). Lumbar rocking test: A new clinical test for predicting lumbar instability. Journal of craniovertebral junction & spine, 10(1), 33–38.