Active Straight Leg Raise Test (aSLR): Difference between revisions
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== Background == | == Background == | ||
The Active Straight Leg Raise (aSLR) is a test used to assess load transference through the pelvis. It is an important test in diagnosing Pelvic Girdle Pain (PGP).<ref>''Hu H, Meijer OG, Hodges PW, Bruijn SM, Strijers RL, Nanayakkara PWB, van Royen BJ, Wu W, Xia C, van Dieën JH. Understanding the Active Straight Leg Raise (ASLR): An electromyographic study in healthy subjects. Manual Therapy,'' 2012; ''17(6):531–537.''</ref> The PGP could affect pregnant women, athletes with groin pain | The Active Straight Leg Raise (aSLR) is a test used to assess load transference through the pelvis. It is an important test in diagnosing Pelvic Girdle Pain (PGP).<ref>''Hu H, Meijer OG, Hodges PW, Bruijn SM, Strijers RL, Nanayakkara PWB, van Royen BJ, Wu W, Xia C, van Dieën JH. Understanding the Active Straight Leg Raise (ASLR): An electromyographic study in healthy subjects. Manual Therapy,'' 2012; ''17(6):531–537.''</ref> The PGP could affect pregnant women, or be not pregnancy related as in athletes with groin pain or it can occours after a trauma. The aSLR test is considered positive when it elicits pain in the lumbo-pelvic region or it point out a Motor Control (MC) dysfunction. | ||
Some study also suggests that the aSLR test should be used with other functional evolution tests to isolate the cause of Low Back Pain<ref>Krkeljas Z, Kovac D. . Relationship between ASLR and motor control impairment tests in physically active individuals with and without low back pain. (2018); 8: 5-15. </ref>. | |||
Clinical observations also show that patients with [[Sacroiliac Joint Syndrome|sacroiliac joint pain]] have suboptimal MC strategies and alterations in respiratory function when performing low-load tasks such as an active straight leg raise<ref name=":0">O'Sullivan PB, Beales DJ, Beetham JA, Cripps J, Graf F, Lin IB, Tucker B, Avery A. Altered motor control strategies in subjects with sacroiliac joint pain during the active straight-leg-raise test. Spine (Phila Pa 1976). 2002 Jan 1;27(1):E1-8</ref>. | |||
For more information please see [[Recognising Pelvic Girdle Pain]] | For more information please see [[Recognising Pelvic Girdle Pain]] | ||
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== Purpose == | == Purpose == | ||
In the past it has been suggest that patients with PGP lack the ability to stabilize the pelvic girdle, probably due to instability or increased movement of the sacroiliac joint.<ref>Mens JM, Vleeming A, Snijders CJ, Stam HJ, Ginai AZ. The active straight leg raising test and mobility of the pelvic joints. Eur Spine J. 1999;8(6):468-73.</ref> However a more recent study contradict the hypotesys that a forward rotation of the lifted leg's joint occur while performing the aSLR.<ref>Kibsgård TJ, Röhrl SM, Røise O, Sturesson B, Stuge B. Movement of the sacroiliac joint during the Active Straight Leg Raise test in patients with long-lasting severe sacroiliac joint pain. Clin Biomech (Bristol, Avon). 2017 Aug;47:40-45</ref>It is more reasonable that aSLR is not the evaluation test for the stability of sacoiliac joint but a stress-test for the capacity to trasfer the load between legs and lumbo-pelvic structures. As a matter of fact during testing, assessment of the primary subjective feature of heaviness of the leg (or pain) is complimented by observation of motor control (MC) adaptations such as respiratory disruption and abdominal bracing<ref>Beales DJ, O'Sullivan PB, Briffa NK. Motor control patterns during an active straight leg raise in chronic pelvic girdle pain subjects. Spine (Phila Pa 1976). 2009 Apr 20;34(9):861-70.</ref><ref name=":0" />. Furthermore some studies<ref>Snijders C, Vleeming A, Stoeckart R. Transfer of lumbosacral load to iliac bones and legs, part 1: biomechanics of self-bracing of the sacroiliac joints and its significance for treatment and exercise. Clin Biomech 1993;8:285–94</ref> investigated the biomechanical models and their connection with lumbopelvic stability. Accordingly to that, licterature supports the hypothesis of aberrant MC patterns providing a mechanism for ongoing pain in specific PGP presentations. | |||
== Technique == | == Technique == | ||
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== Evidence == | == Evidence == | ||
This supports the reliability of the ASLR test.<ref>Mens JM, Pool-Goudzwaard A, Beekmans RE, Tijhuis MT. Relation between subjective and objective scores on the active straight leg raising test. Spine (Phila Pa 1976). 2010 Feb 1;35(3):336-9</ref> | |||
== Resources == | == Resources == | ||
Revision as of 20:50, 14 December 2021
Background[edit | edit source]
The Active Straight Leg Raise (aSLR) is a test used to assess load transference through the pelvis. It is an important test in diagnosing Pelvic Girdle Pain (PGP).[1] The PGP could affect pregnant women, or be not pregnancy related as in athletes with groin pain or it can occours after a trauma. The aSLR test is considered positive when it elicits pain in the lumbo-pelvic region or it point out a Motor Control (MC) dysfunction.
Some study also suggests that the aSLR test should be used with other functional evolution tests to isolate the cause of Low Back Pain[2].
Clinical observations also show that patients with sacroiliac joint pain have suboptimal MC strategies and alterations in respiratory function when performing low-load tasks such as an active straight leg raise[3].
For more information please see Recognising Pelvic Girdle Pain
Purpose[edit | edit source]
In the past it has been suggest that patients with PGP lack the ability to stabilize the pelvic girdle, probably due to instability or increased movement of the sacroiliac joint.[4] However a more recent study contradict the hypotesys that a forward rotation of the lifted leg's joint occur while performing the aSLR.[5]It is more reasonable that aSLR is not the evaluation test for the stability of sacoiliac joint but a stress-test for the capacity to trasfer the load between legs and lumbo-pelvic structures. As a matter of fact during testing, assessment of the primary subjective feature of heaviness of the leg (or pain) is complimented by observation of motor control (MC) adaptations such as respiratory disruption and abdominal bracing[6][3]. Furthermore some studies[7] investigated the biomechanical models and their connection with lumbopelvic stability. Accordingly to that, licterature supports the hypothesis of aberrant MC patterns providing a mechanism for ongoing pain in specific PGP presentations.
Technique[edit | edit source]
The ASLR consists of ipsilateral hip flexion, a contralateral hip extension moment, force closure by the lateral abdominal muscles, sagittal plane pelvis stabilization by the abdominal wall, and activity of contralateral transverse plane rotators of the pelvis. Problems with the ASLR may result from failing force closure. Other tests are available to confirm, or falsify, the clinical hypothesis that the patient is having problems with force closure.
Evidence[edit | edit source]
This supports the reliability of the ASLR test.[8]
Resources[edit | edit source]
- ↑ Hu H, Meijer OG, Hodges PW, Bruijn SM, Strijers RL, Nanayakkara PWB, van Royen BJ, Wu W, Xia C, van Dieën JH. Understanding the Active Straight Leg Raise (ASLR): An electromyographic study in healthy subjects. Manual Therapy, 2012; 17(6):531–537.
- ↑ Krkeljas Z, Kovac D. . Relationship between ASLR and motor control impairment tests in physically active individuals with and without low back pain. (2018); 8: 5-15.
- ↑ 3.0 3.1 O'Sullivan PB, Beales DJ, Beetham JA, Cripps J, Graf F, Lin IB, Tucker B, Avery A. Altered motor control strategies in subjects with sacroiliac joint pain during the active straight-leg-raise test. Spine (Phila Pa 1976). 2002 Jan 1;27(1):E1-8
- ↑ Mens JM, Vleeming A, Snijders CJ, Stam HJ, Ginai AZ. The active straight leg raising test and mobility of the pelvic joints. Eur Spine J. 1999;8(6):468-73.
- ↑ Kibsgård TJ, Röhrl SM, Røise O, Sturesson B, Stuge B. Movement of the sacroiliac joint during the Active Straight Leg Raise test in patients with long-lasting severe sacroiliac joint pain. Clin Biomech (Bristol, Avon). 2017 Aug;47:40-45
- ↑ Beales DJ, O'Sullivan PB, Briffa NK. Motor control patterns during an active straight leg raise in chronic pelvic girdle pain subjects. Spine (Phila Pa 1976). 2009 Apr 20;34(9):861-70.
- ↑ Snijders C, Vleeming A, Stoeckart R. Transfer of lumbosacral load to iliac bones and legs, part 1: biomechanics of self-bracing of the sacroiliac joints and its significance for treatment and exercise. Clin Biomech 1993;8:285–94
- ↑ Mens JM, Pool-Goudzwaard A, Beekmans RE, Tijhuis MT. Relation between subjective and objective scores on the active straight leg raising test. Spine (Phila Pa 1976). 2010 Feb 1;35(3):336-9
