Special Tests: Neurodynamic Testing
by Brent Brookbush DPT, PT, COMT, MS, PES, CES, CSCS, ACSM H/FS
For an introduction to Special Tests including definitions of specific terminology, what special tests measure, how we chose the tests in these lessons, and best use, check out:
Special Tests Covered in this Lesson:
- Neurodynamic Tests
The body of research regarding lower extremity nerve tension tests continues to grow; however, additional research is needed to answer clinically relevant questions. Studies have demonstrated validity; that is, neurodynamic testing results in lengthening and gliding of nerves (22-25). However, further research is needed to demonstrate motion of the intended nerve during each of the tests in this course, and the various modifications of each test. Generally, neurodynamic tests have demonstrated higher sensitivity than specificity (4 - 21, 29 - 31); however, a few studies imply specificity increases when various modifications are added to the Straight Leg Raise Test (8-11, 17 - 21). More consideration needs to be given to what diagnoses are associated with a "positive test" (lumbar herniation, radiculopathy, neurogenic symptoms, etc.), as diagnoses vary between studies resulting in a wide range of findings regarding test accuracy. Although a significant amount of research has been published, more research will undoubtedly refine understanding of these potentially useful tests.
Straight Leg Raise Test, Well Leg Raise Sign and Sensitization
Straight Leg Raise Test (SLR)
- The patient assumes a supine position on a firm surface with head and neck in neutral position, and lower extremities in line with hips.
- The examiner then uses one hand on the heel to gently raise the affected leg into flexion.
- Note: Initially this test is performed with out hip