Bowstring Sign: Difference between revisions
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== Purpose == | == Purpose == | ||
Bowstring sign is a passive provocative clinical test that is performed in patients presenting with low back pain to determine the lumbosacral nerve tension. | Bowstring sign is a passive provocative clinical test that is performed in patients presenting with [[Low Back Pain|low back pain]] to determine the lumbosacral nerve tension. It is also known as popliteal compression test or posterior tibial nerve stretch sign.<ref>Das JM, Nadi M. [https://www.ncbi.nlm.nih.gov/books/NBK545299/ Lasegue Sign]. StatPearls [Internet]. 2020 May 24.</ref> | ||
== Technique == | == Technique == | ||
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=== Therapist Position === | === Therapist Position === | ||
Examiner stands at the tested side with face facing towards patient's face. | Examiner stands at the tested side with a face facing towards patient's face. | ||
=== Procedure === | === Procedure === | ||
* Initially, examiner performs [[Straight Leg Raise Test|Straight Leg Raise ( SLR) test]] in which the examiner lifts the leg with the extended knee. Examiner raises the leg to the point where the patient perceives pain along the distribution lumbosacral dermatomal level or when maximum flexion is got. | * Initially, examiner performs [[Straight Leg Raise Test|Straight Leg Raise ( SLR) test]] in which the examiner lifts the leg with the extended knee. Examiner raises the leg to the point where the patient perceives pain along the distribution lumbosacral [https://www.physio-pedia.com/Dermatomes dermatomal level] or when maximum flexion is got. | ||
* While performing SLR test, at the point of maximum pain (positive SLR) the examiner will slightly flex the patient’s knee approximately 20 degrees thereby reducing the pain. | * While performing SLR test, at the point of maximum pain (positive SLR) the examiner will slightly flex the patient’s knee approximately 20 degrees thereby reducing the pain. | ||
* Then examiner applies pressure (via thumb) on the popliteal fossa on sciatic nerve ( | * Then examiner applies pressure (via thumb) on the popliteal fossa on [[Sciatic Nerve|sciatic nerve]] ([[posterior tibial nerve]]). | ||
* If this | * If this elicits the same pain as the patient experiences during SLR, then Bowstring sign is said to be positive.<ref>Kamath, S. U., & Kamath, S. S. (2017). [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483767/ Lasègue's Sign.] ''Journal of clinical and diagnostic research : JCDR'', ''11''(5), RG01–RG02. <nowiki>https://doi.org/10.7860/JCDR/2017/24899.9794</nowiki></ref> | ||
* This test should be performed in both leg,normal side being the first. | * This test should be performed in both leg,normal side being the first. | ||
{{#ev:youtube|dEX43YHaOxQ}}<ref>Sports Injuries And Rehabilitation. Bowstring test. Available from:https://www.youtube.com/watch?v=dEX43YHaOxQ. [Lasted accessed: 26th Feb 2021]</ref> | {{#ev:youtube|dEX43YHaOxQ}}<ref>Sports Injuries And Rehabilitation. Bowstring test. Available from:https://www.youtube.com/watch?v=dEX43YHaOxQ. [Lasted accessed: 26th Feb 2021]</ref> | ||
== Evidence == | == Evidence == | ||
* The bowstring sign is one of the commonly used variants of the SLR test and a study published in 2020 suggests using SLRT, [[Christodoulides test]], [[Slump Test|Slump test,]] and bowstring test in combination. This takes about 2 minutes and could improve both the sensitivity and specificity of the physical examination for the diagnosis of [[sciatica]].<ref>Berthelot JM, Darrieutort-Laffite C, Arnolfo P, Glémarec J, Le Goff B, Maugars Y. [https://europepmc.org/article/med/32561431 Inadequacies of the Lasègue test, and how the Slump and Bowstring tests are useful for the diagnosis of sciatica.] Joint bone spine. 2020 Jun 16:105030.</ref> | |||
== Resources == | == Resources == | ||
Revision as of 15:21, 1 March 2021
Original Editor - Manisha Shrestha Top Contributors - Manisha Shrestha, Kim Jackson, Kirenga Bamurange Liliane and Carina Therese Magtibay
Original Editor - User Name
Top Contributors - Manisha Shrestha, Kim Jackson, Kirenga Bamurange Liliane and Carina Therese Magtibay
Top Contributors - Manisha Shrestha, Kim Jackson, Kirenga Bamurange Liliane and Carina Therese Magtibay
Purpose[edit | edit source]
Bowstring sign is a passive provocative clinical test that is performed in patients presenting with low back pain to determine the lumbosacral nerve tension. It is also known as popliteal compression test or posterior tibial nerve stretch sign.[1]
Technique[edit | edit source]
Patient Position[edit | edit source]
Patient in supine lying position without a pillow.
Therapist Position[edit | edit source]
Examiner stands at the tested side with a face facing towards patient's face.
Procedure[edit | edit source]
- Initially, examiner performs Straight Leg Raise ( SLR) test in which the examiner lifts the leg with the extended knee. Examiner raises the leg to the point where the patient perceives pain along the distribution lumbosacral dermatomal level or when maximum flexion is got.
- While performing SLR test, at the point of maximum pain (positive SLR) the examiner will slightly flex the patient’s knee approximately 20 degrees thereby reducing the pain.
- Then examiner applies pressure (via thumb) on the popliteal fossa on sciatic nerve (posterior tibial nerve).
- If this elicits the same pain as the patient experiences during SLR, then Bowstring sign is said to be positive.[2]
- This test should be performed in both leg,normal side being the first.
Evidence[edit | edit source]
- The bowstring sign is one of the commonly used variants of the SLR test and a study published in 2020 suggests using SLRT, Christodoulides test, Slump test, and bowstring test in combination. This takes about 2 minutes and could improve both the sensitivity and specificity of the physical examination for the diagnosis of sciatica.[4]
Resources[edit | edit source]
add any relevant resources here
References[edit | edit source]
- ↑ Das JM, Nadi M. Lasegue Sign. StatPearls [Internet]. 2020 May 24.
- ↑ Kamath, S. U., & Kamath, S. S. (2017). Lasègue's Sign. Journal of clinical and diagnostic research : JCDR, 11(5), RG01–RG02. https://doi.org/10.7860/JCDR/2017/24899.9794
- ↑ Sports Injuries And Rehabilitation. Bowstring test. Available from:https://www.youtube.com/watch?v=dEX43YHaOxQ. [Lasted accessed: 26th Feb 2021]
- ↑ Berthelot JM, Darrieutort-Laffite C, Arnolfo P, Glémarec J, Le Goff B, Maugars Y. Inadequacies of the Lasègue test, and how the Slump and Bowstring tests are useful for the diagnosis of sciatica. Joint bone spine. 2020 Jun 16:105030.
