ACTIVE STRAIGHT

LEG RAISE.
By – Tasneem M Nava.
Alafiya Imani.
Ambika Badrinath.
 Introduction.
 The supine active straight leg raise test
(ASLR) (Mens et al 2001, 2002) has been
validated as a clinical indicator of lumbopelvic
stability.
 As a whole it places emphasis on the form
closure and force closure occuring at the
pelvis, which are the key factors for stability.
 Things to prevent

 The pelvis should not move relative to the thorax and/or lower
extremity.
 This requires proper activation of the muscles which stabilize
the thorax, low back and pelvis.
 Rib cage should not draw in excessively (over-activation of
the external oblique muscles) and Lower ribs should not flare
out excessively (over-activation of the internal oblique
muscles). Affects inspiration.
 Thoracic spine should not extend (over-activation of the
erector spinae), nor should the abdomen bulge (valsalva).
 Also the thorax should not shift laterally relative to the pelvic
girdle.
 Procedure
 The pt (lying supine) is asked to lift their
extended leg off the table and to note any
effort difference between the L and R leg
(does one leg seem heavier or harder to lift?).
 The leg should rise effortlessly from the table.
 Provocation of any pelvic pain is noted.
 The pelvis is then compressed passively* and
the ASLR is repeated; any change in effort
and/or pain is noted.
 *Passive compression of
 -ant pelvis at the level of the ASIS’s simulates force
produced by contraction of lower fibres of trans. Ab
(& ant abd fascia).
 -post pelvis at the level of the PSIS’s simulates that of
the sacral multifidus (and the TLF).
 -ant pelvis at the level of the pubic symphysis
simulates the action of the ant pelvic floor.
 -post pelvis at the level of the ischial tuberosities
simulates action of the post pelvic wall and floor.
 Procedure
 Compression can also be applied to one side
anteriorly and simultaneously to the opposite side
posteriorly.
 Note for the location where more (or less)
compression reduces the effort necessary to lift the
leg.
 Either compress passively (form closure) or activate
the core muscles (force closure) by asking the patient
to tighten his tummy or asking him to resist your
push to his extended arm diagonally, and note for
changes.
 Interpretation
 Sensitivity- 91%
 Specificity- 26%
 If the patient is able to lift the leg better once
the pelvis is compressed or when the core is
activated forcibly -- the corresponding muscles
are thought to be weak and contributing to
pain and instability.
 The above can be further confirmed by testing
its strength.
 Therapy
 Belts – used to maintain form.
 Strengthening exs – to regain force closure at
the pelvis.
 Gradual weaning off the belts with more
emphasis on exs progressively.
 THANK YOU
Reference:
www.kalindra.com/LoadTransfertests
.pdf