Nerve Stretch Tests.
Lie patient on their back.
Knee extended, elevate the leg.
Criteria for positive test
- Pain at 30 to 70 degrees
- Aggravation of pain dorsiflexion of the foot
- Relief of pain by knee flexion
Interpretation: What patient experiences
- Radiating pain into the legs
- Suggests radiculopathy
- Higher likelihood findings suggesting radiculopathy
- Excruciating Sciatica-like pain
- Pain occurs at 30 to 40 degrees of leg elevation
- Pain radiates into opposite leg (Crossed straight leg raise)
- Indicates severe impingement
- Almost always due to a large disk herniation
I don't know why but I seem to find sources saying that Lasegue and Bragard's they're both the same thing.. Can someone clarify? :S Is it because one test follows the other? Or that we have to do both tests? HUH?! :(
Bragard's test :
Elevate the leg, dorsiflex the foot.
Is there pain?
Return the foot back to the normal position
Lasegue's test :
Now, flex the knee. There shouldn't be any pain.
Extend the knee again, and the patient feels a pain.
Such pain would indicate sciatica and spinal cord nerve root compression
Cross straight leg :
Lifting the healthy leg would cause pain in the other.
Straight leg raise
Test Sensitivity: Up to 98%
Test Specificity: Up to 61%
Crossed straight leg raise
Test Sensitivity: Up to 43%
Test Specificity: Up to 98%
*sensitivity : pateints with disease who has physical sign.
* specificity : patients without the disease who lack the physical sign.
Reference :
http://www.fpnotebook.com/Ortho/Exam/StrghtLgRs.htm
http://www.stanleyconsulting.ns.ca/Files/Neuro_Ortho_Tests.pdf
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ReplyDeletei think these two tests (lasgue and bragard) are considered the same coz they testing the same thing....the same nerve will be over extended and hurt or something in both these tests...and its the same mechanism in which the nerve is being extended...agree??
ReplyDeletethe way i understand it bragards test u just elevate the foot and then dorsiflex which will lead to the patient feeling increased pain, and if u then return the foot to the normal position while the leg is elevated and then do the lasegue's test which u have to bend the whole limb at the knee the pain goes away and comes back when u extend the knee again means its positive for sciatic nerve problem or wutever.
ReplyDeleteits jus tht the two tests confirm each other and the same condition i guess it can be considered as one.