Use of Neurodynamic or Orthopedic Tension Tests for the Diagnosis of Lumbar and Lumbosacral Radiculopathies: Study of the Diagnostic Validity

Francisco Javier González Espinosa de los Monteros, Gloria Gonzalez-Medina, Elisa Maria Garrido Ardila, Juan Rodríguez Mansilla, José Paz Expósito and Petronila Oliva Ruiz
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Francisco Javier González Espinosa de los Monteros: Andalusian Health Service, Hospital “Puerta Universitario del Mar”, Av. Ana de Viya, 21, 11009 Cádiz, Spain
Gloria Gonzalez-Medina: Nursing and Physiotherapy Department, Cadiz University, Av. Ana de Viya, 52, 11009 Cadiz, Spain
Elisa Maria Garrido Ardila: Department of Medical-Surgical Therapy, Medicine Faculty, Extremadura University, 06006 Badajoz, Spain
Juan Rodríguez Mansilla: Department of Medical-Surgical Therapy, Medicine Faculty, Extremadura University, 06006 Badajoz, Spain
José Paz Expósito: Andalusian Health Service, Hospital “Puerta Universitario del Mar”, Av. Ana de Viya, 21, 11009 Cádiz, Spain
Petronila Oliva Ruiz: Nursing and Physiotherapy Department, Cadiz University, Av. Ana de Viya, 52, 11009 Cadiz, Spain

IJERPH, 2020, vol. 17, issue 19, 1-12

Abstract: Background: Lumbar radiculopathy is a nerve root disorder whose correct diagnosis is essential. The objective of the present study was to analyze the reliability diagnostic validity of eight neurodynamic and/or orthopedic tension tests using magnetic resonance imaging as the Gold Standard. Methods: An epidemiological study of randomized consecutive cases which was observational, descriptive, transversal, double blinded and was conducted following the Standards for Reporting Diagnostic accuracy studies (STARD) declaration. The sample size was 864 participants. Internal and external validity (CI = 95%) and reliability, were calculated for all tests performed independently. The diagnostic validity of the combined and multiple tests in parallel was also calculated. Results: The analysis indicated that only two tests performed independently had external validity, but neither had reliability or precision. The Straight Leg Raise test and the Bragard test performed in a multiple parallel way showed high sensitivity (97.40%), high negative predictive value (PV− 96.64%) and external validity (Likelihood Ratio− 0.05). The combined test of the Slump test and the Dejerine’s triad had internal and external validity. Conclusions: The Straight Leg Raise test and the Bragard test performed in a multiple parallel way and the combined test of the Slump Test and the Dejerine’s triad have clinical validity to discard lumbar or lumbar-sacral radiculopathy.

Keywords: lumbar radiculopathy; neurodynamic tension tests; orthopedic tension tests; magnetic resonance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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