Reliability and Validity of the Active Straight Leg Raise Test in Posterior Pelvic Pain Since Pregnancy

SPINE Volume 26, Number 10, pp 1167–1171 ©2001, Lippincott Williams & Wilkins, Inc.

Reliability and Validity of the Active Straight Leg Raise Test in Posterior Pelvic Pain Since Pregnancy
Jan M. A. Mens, MD,*† Andry Vleeming, PhD,* Chris J. Snijders, PhD,‡ Bart W. Koes, PhD,§ and Henk J. Stam, MD, PhD†
Pregnancy is frequently complicated by the occurrence of lumbopelvic pain; the reported cumulative 9-month incidence ranges from 48%-56%.2,4,8,12 Posterior pelvic pain since pregnancy (PPPP) is often described as a distinct category.7,12,13,17 It remains questionable whether PPPP is a specific syndrome or just nonspecific lumbopelvic pain with an onset during pregnancy or delivery. Regardless of the answer, detailed study on the characteristics of PPPP could provide better understanding of lumbopelvic pain in general. To discriminate patients with PPPP from healthy subjects, various instruments have been investigated. Mobility of the pelvic joints assessed by the Chamberlain method showed a range of motion between the pubic bones of 5.9 3.3 mm in puerperal women with pelvic pain since pregnancy and 1.9 2.2 mm in a group of puerperal women without pelvic pain.1,3 As far as is known, the specificity of this method was never studied in PPPP with a disease duration exceeding 6 months. In two studies in pregnant women the posterior pelvic pain provocation test (PPPP test) scored high both on sensitivity (0.69 – 0.81) and specificity (0.80 – 0.90). 7,13 ‘‘Catching’’ of the leg (the phenomenon whereby a patient feels difficulty in moving one or both legs forward when walking) is described as a diagnostic sign in PPPP.17 The specificity of this sign was similar to that of the PPPP test, but its sensitivity was much lower; the reliability of this sign has, as far as we know, never been investigated. The setting provides the opportunity to examine a large group of patients with PPPP. It was noticed that in most patients active raising of one or both legs in the supine position

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