Extending the straight leg raise test for improved clinical evaluation of sciatica: reliability of hip internal rotation or ankle dorsiflexion

Abstract Background The straight leg raise (SLR) is the most commonly applied physical tests on patients with sciatica, but sensitivity and specificity ratings for disc hernia neural compression leave areas improvement. Hip internal rotation tensions lumbosacral nerve roots ankle dorsiflexion sciatic along its course. We added these movements to SLR (extended = ESLR) as structural differentiators tested inter-rater reliability in LBP, without sciatica. Methods Forty subjects were recruited study by controller (SC), 20 group control group. Two independent examiners (E1&E2) performed ESLR did not communicate other than needed determine outcome of ESLR. First, was traditionally until first responses evoked. At this hip flexion angle, a location-specific differentiation confirm whether emerged origin. Cohen’s Kappa score (CK) interrater calculated result detection patients. Also, examiners’ results compared traditional results. Results agreement between Examiner 1 2 0.85 ( p < 0.001, 95%CI: 0.71–0.99) translating almost perfect measured When SLR, overall rate 75% (30/40). values E1’s or E2’s 0.50 0.0001; 95%CI 0.27–0.73) 0.54 (p 0.30–0.77), respectively. Conclusions addition reliable repeatable tool discerning symptoms from musculoskeletal radiating low back pain. recommend adding standard aim improving diagnostic ability.