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Henk J Stam - One of the best experts on this subject based on the ideXlab platform.
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validity of the active Straight Leg Raise test for measuring disease severity in patients with posterior pelvic pain after pregnancy
Spine, 2002Co-Authors: Jan M A Mens, Andry Vleeming, Chris J Snijders, Bart W Koes, Henk J StamAbstract:STUDY DESIGN: A cross-sectional analysis was performed with a group of women meeting strict criteria for posterior pelvic pain after pregnancy. The active Straight Leg Raise test and common severity measurement scales of lumbopelvic pain were scored. OBJECTIVE: To assess the validity of the active Straight Leg Raise test as a disease severity scale for patients with posterior pelvic pain after pregnancy. SUMMARY OF BACKGROUND DATA: Various diagnostic tools are used to measure disease severity in patients with posterior pelvic pain after pregnancy, but simple tests with high reliability and validity still are needed. METHODS: The investigation was performed with 200 women who had posterior pelvic pain after pregnancy. The validity of the active Straight Leg Raise test as a severity scale was investigated by comparing the test score with the medical history, scores on self-reported disability scales, pain and tiredness, and pain provocation tests. The usefulness of the active Straight Leg Raise test as a severity scale was compared with that of the Quebec Back Pain Disability Scale. The influence of several demographic and anthropometric variables on the active Straight Leg Raise score was investigated. RESULTS: The active Straight Leg Raise score ranged from 0 to 10 and correlated as expected with all severity scales. The correlation between the scores on the active Straight Leg Raise test and the Quebec Back Pain Disability Scale was 0.70. No association was found between the active Straight Leg Raise score and age, parity, duration of the postpartum period, height, or weight. CONCLUSION: The active Straight Leg Raise test can be recommended as a disease severity scale for patients with posterior pelvic pain after pregnancy.
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reliability and validity of the active Straight Leg Raise test in posterior pelvic pain since pregnancy
Spine, 2001Co-Authors: Jan M A Mens, Andry Vleeming, Chris J Snijders, Bart W Koes, Henk J StamAbstract:Study Design. A cross-sectional analysis was performed in a group of women meeting strict criteria for posterior pelvic pain since pregnancy (PPPP). The scores on the Active Straight Leg Raise Test (ASLR test) were compared with the scores of healthy controls. Objectives. To develop a new diagnostic instrument for use in patients with PPPP. The objectives of the present study were to assess the validity and reliability of the ASLR test. Summary of Background Data. Various diagnostic tools are used to diagnose PPPP, but there is still a need for simple tests with high reliability, sensitivity, and specificity. Methods. Reliability of the ASLR test was assessed in a group of 50 women with lumbopelvic pain of various etiologies and various degrees of severity; Sensitivity was assessed in 200 patients with PPPP and specificity in 50 healthy women. Sensitivity and specificity of the ASLR test were compared with the posterior pelvic pain provocation test (PPPP test). Results. The test-retest reliability measured with Pearson's correlation coefficient between the two ASLR scores 1 week apart was 0.87. The intraclass correlation coefficient (ICC) was 0.83. Pearson's correlation coefficient between the scores of the patient and the scores of a blinded assessor was 0.78; the ICC was 0.77. In the patient group, the ASLR score ranged from 0-10; in the control group it ranged from 0-2. The best balance between specificity and sensitivity was found when scores 1-10 are designated as positive and zero as negative. With this cut-off point sensitivity of the test was 0.87 and specificity was 0.94. The sensitivity of the ASLR test is higher than the sensitivity of the PPPP test; an advantage of the ASLR test is the simplicity of measuring the score. Conclusion. The ASLR test is a suitable diagnostic instrument to discriminate between patients who are disabled by PPPP and healthy subjects. The test is easy to perform; reliability, sensitivity, and specificity are high. It seems that the integrity of the function to transfer loads between the lumbosacral spine and Legs is tested by the ASLR test.
Darren Beales - One of the best experts on this subject based on the ideXlab platform.
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the effects of manual pelvic compression on trunk motor control during an active Straight Leg Raise in chronic pelvic girdle pain subjects
Manual Therapy, 2010Co-Authors: Darren Beales, Peter Osullivan, Kathryn N BriffaAbstract:Abstract A sub-group of pelvic girdle pain (PGP) patients with a positive active Straight Leg Raise (ASLR) responds positively to the application of external pelvic compression during the test. This study investigated the effect of this phenomenon on electromyographic (EMG) activity of the trunk muscles and intra-abdominal and intra-thoracic pressures in subjects with a unilateral sacroiliac joint (SIJ) pain disorder ( n =12). All subjects reported reduced difficulty ratings during an ASLR with pelvic compression (paired t -test: p
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the effects of manual pelvic compression on trunk motor control during an active Straight Leg Raise in chronic pelvic girdle pain subjects
Manual Therapy, 2010Co-Authors: Darren Beales, Peter Osullivan, Kathryn N BriffaAbstract:A sub-group of pelvic girdle pain (PGP) patients with a positive active Straight Leg Raise (ASLR) responds positively to the application of external pelvic compression during the test. This study investigated the effect of this phenomenon on electromyographic (EMG) activity of the trunk muscles and intra-abdominal and intra-thoracic pressures in subjects with a unilateral sacroiliac joint (SIJ) pain disorder (n=12). All subjects reported reduced difficulty ratings during an ASLR with pelvic compression (paired t-test: p<0.001), yet no statistically significant changes in the muscle activation or pressure variables were found. However, visual inspection of the data revealed two divergent motor control strategies with the addition of compression. Seven subjects displayed characteristics of a decreased EMG profile, while in the other five subjects the EMG profile appeared to increase. As such this study provides preliminary evidence of two disparate patterns of motor control in response to the addition of pelvic compression to an ASLR. The findings may reflect different mechanisms, not only in the response to pelvic compression, but also of the underlying PGP disorder.
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motor control patterns during an active Straight Leg Raise in chronic pelvic girdle pain subjects
Spine, 2009Co-Authors: Darren Beales, Peter Osullivan, Kathryn N BriffaAbstract:STUDY DESIGN: Repeated measures. OBJECTIVE: To investigate motor control (MC) patterns in chronic pelvic girdle pain (PGP) subjects during an active Straight Leg Raise (ASLR). SUMMARY OF BACKGROUND DATA: The ASLR is a test used to assess load transference through the pelvis. Altered MC patterns have been reported in subjects with chronic PGP during this test. These patterns may impede efficient load transfer, while having the potential to impinge on respiratory function and/or to adversely affect the control of continence. METHODS: Twelve female subjects with chronic PGP were examined. Electromyography of the anterior abdominal wall, right chest wall and the scalene, intraabdominal pressure, intrathoracic pressure, respiratory rate, pelvic floor kinematics, and downward Leg pressure of the nonlifted Leg were compared between an ASLR lifting the Leg on the affected side of the body versus the nonaffected side. RESULTS: Performing an ASLR lifting the Leg on the affected side of the body resulted in a predominant MC pattern of bracing through the abdominal wall and the chest wall. This was associated with increased baseline shift in intraabdominal pressure and depression of the pelvic floor when compared with an ASLR lifting the Leg on the nonaffected side. CONCLUSION: This MC pattern, identified during an ASLR on the affected side of the body, has the potential to be a primary mechanism driving ongoing pain and disability in chronic PGP subjects.
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altered motor control strategies in subjects with sacroiliac joint pain during the active Straight Leg Raise test
Spine, 2002Co-Authors: Peter Osullivan, Darren Beales, Julie A Beetham, Jillian Cripps, Felicitas Graf, Beatrice Tucker, Anita AveryAbstract:STUDY DESIGN: An experimental study of respiratory function and kinematics of the diaphragm and pelvic floor in subjects with a clinical diagnosis of sacroiliac joint pain and in a comparable pain-free subject group was conducted. OBJECTIVE: To gain insight into the motor control strategies of subjects with sacroiliac joint pain and the resultant effect on breathing pattern. SUMMARY OF BACKGROUND DATA: The active Straight-Leg-Raise test has been proposed as a clinical test for the assessment of load transfer through the pelvis. Clinical observations show that patients with sacroiliac joint pain have suboptimal motor control strategies and alterations in respiratory function when performing low-load tasks such as an active Straight Leg Raise. METHODS: In this study, 13 participants with a clinical diagnosis of sacroiliac joint pain and 13 matched control subjects in the supine resting position were tested with the active Straight Leg Raise and the active Straight Leg Raise with manual compression through the ilia. Respiratory patterns were recorded using spirometry, and minute ventilation was calculated. Diaphragmatic excursion and pelvic floor descent were measured using ultrasonography. RESULTS: The participants with sacroiliac joint pain exhibited increased minute ventilation, decreased diaphragmatic excursion, and increased pelvic floor descent, as compared with pain-free subjects. Considerable variation was observed in respiratory patterns. Enhancement of pelvis stability via manual compression through the ilia reversed these differences. CONCLUSIONS: The study findings formally identified altered motor control strategies and alterations of respiratory function in subjects with sacroiliac joint pain. The changes observed appear to represent a compensatory strategy of the neuromuscular system to enhance force closure of the pelvis where stability has been compromised by injury.
Peter Osullivan - One of the best experts on this subject based on the ideXlab platform.
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the effects of manual pelvic compression on trunk motor control during an active Straight Leg Raise in chronic pelvic girdle pain subjects
Manual Therapy, 2010Co-Authors: Darren Beales, Peter Osullivan, Kathryn N BriffaAbstract:Abstract A sub-group of pelvic girdle pain (PGP) patients with a positive active Straight Leg Raise (ASLR) responds positively to the application of external pelvic compression during the test. This study investigated the effect of this phenomenon on electromyographic (EMG) activity of the trunk muscles and intra-abdominal and intra-thoracic pressures in subjects with a unilateral sacroiliac joint (SIJ) pain disorder ( n =12). All subjects reported reduced difficulty ratings during an ASLR with pelvic compression (paired t -test: p
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the effects of manual pelvic compression on trunk motor control during an active Straight Leg Raise in chronic pelvic girdle pain subjects
Manual Therapy, 2010Co-Authors: Darren Beales, Peter Osullivan, Kathryn N BriffaAbstract:A sub-group of pelvic girdle pain (PGP) patients with a positive active Straight Leg Raise (ASLR) responds positively to the application of external pelvic compression during the test. This study investigated the effect of this phenomenon on electromyographic (EMG) activity of the trunk muscles and intra-abdominal and intra-thoracic pressures in subjects with a unilateral sacroiliac joint (SIJ) pain disorder (n=12). All subjects reported reduced difficulty ratings during an ASLR with pelvic compression (paired t-test: p<0.001), yet no statistically significant changes in the muscle activation or pressure variables were found. However, visual inspection of the data revealed two divergent motor control strategies with the addition of compression. Seven subjects displayed characteristics of a decreased EMG profile, while in the other five subjects the EMG profile appeared to increase. As such this study provides preliminary evidence of two disparate patterns of motor control in response to the addition of pelvic compression to an ASLR. The findings may reflect different mechanisms, not only in the response to pelvic compression, but also of the underlying PGP disorder.
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motor control patterns during an active Straight Leg Raise in chronic pelvic girdle pain subjects
Spine, 2009Co-Authors: Darren Beales, Peter Osullivan, Kathryn N BriffaAbstract:STUDY DESIGN: Repeated measures. OBJECTIVE: To investigate motor control (MC) patterns in chronic pelvic girdle pain (PGP) subjects during an active Straight Leg Raise (ASLR). SUMMARY OF BACKGROUND DATA: The ASLR is a test used to assess load transference through the pelvis. Altered MC patterns have been reported in subjects with chronic PGP during this test. These patterns may impede efficient load transfer, while having the potential to impinge on respiratory function and/or to adversely affect the control of continence. METHODS: Twelve female subjects with chronic PGP were examined. Electromyography of the anterior abdominal wall, right chest wall and the scalene, intraabdominal pressure, intrathoracic pressure, respiratory rate, pelvic floor kinematics, and downward Leg pressure of the nonlifted Leg were compared between an ASLR lifting the Leg on the affected side of the body versus the nonaffected side. RESULTS: Performing an ASLR lifting the Leg on the affected side of the body resulted in a predominant MC pattern of bracing through the abdominal wall and the chest wall. This was associated with increased baseline shift in intraabdominal pressure and depression of the pelvic floor when compared with an ASLR lifting the Leg on the nonaffected side. CONCLUSION: This MC pattern, identified during an ASLR on the affected side of the body, has the potential to be a primary mechanism driving ongoing pain and disability in chronic PGP subjects.
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altered motor control strategies in subjects with sacroiliac joint pain during the active Straight Leg Raise test
Spine, 2002Co-Authors: Peter Osullivan, Darren Beales, Julie A Beetham, Jillian Cripps, Felicitas Graf, Beatrice Tucker, Anita AveryAbstract:STUDY DESIGN: An experimental study of respiratory function and kinematics of the diaphragm and pelvic floor in subjects with a clinical diagnosis of sacroiliac joint pain and in a comparable pain-free subject group was conducted. OBJECTIVE: To gain insight into the motor control strategies of subjects with sacroiliac joint pain and the resultant effect on breathing pattern. SUMMARY OF BACKGROUND DATA: The active Straight-Leg-Raise test has been proposed as a clinical test for the assessment of load transfer through the pelvis. Clinical observations show that patients with sacroiliac joint pain have suboptimal motor control strategies and alterations in respiratory function when performing low-load tasks such as an active Straight Leg Raise. METHODS: In this study, 13 participants with a clinical diagnosis of sacroiliac joint pain and 13 matched control subjects in the supine resting position were tested with the active Straight Leg Raise and the active Straight Leg Raise with manual compression through the ilia. Respiratory patterns were recorded using spirometry, and minute ventilation was calculated. Diaphragmatic excursion and pelvic floor descent were measured using ultrasonography. RESULTS: The participants with sacroiliac joint pain exhibited increased minute ventilation, decreased diaphragmatic excursion, and increased pelvic floor descent, as compared with pain-free subjects. Considerable variation was observed in respiratory patterns. Enhancement of pelvis stability via manual compression through the ilia reversed these differences. CONCLUSIONS: The study findings formally identified altered motor control strategies and alterations of respiratory function in subjects with sacroiliac joint pain. The changes observed appear to represent a compensatory strategy of the neuromuscular system to enhance force closure of the pelvis where stability has been compromised by injury.
Kathryn N Briffa - One of the best experts on this subject based on the ideXlab platform.
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the effects of manual pelvic compression on trunk motor control during an active Straight Leg Raise in chronic pelvic girdle pain subjects
Manual Therapy, 2010Co-Authors: Darren Beales, Peter Osullivan, Kathryn N BriffaAbstract:Abstract A sub-group of pelvic girdle pain (PGP) patients with a positive active Straight Leg Raise (ASLR) responds positively to the application of external pelvic compression during the test. This study investigated the effect of this phenomenon on electromyographic (EMG) activity of the trunk muscles and intra-abdominal and intra-thoracic pressures in subjects with a unilateral sacroiliac joint (SIJ) pain disorder ( n =12). All subjects reported reduced difficulty ratings during an ASLR with pelvic compression (paired t -test: p
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the effects of manual pelvic compression on trunk motor control during an active Straight Leg Raise in chronic pelvic girdle pain subjects
Manual Therapy, 2010Co-Authors: Darren Beales, Peter Osullivan, Kathryn N BriffaAbstract:A sub-group of pelvic girdle pain (PGP) patients with a positive active Straight Leg Raise (ASLR) responds positively to the application of external pelvic compression during the test. This study investigated the effect of this phenomenon on electromyographic (EMG) activity of the trunk muscles and intra-abdominal and intra-thoracic pressures in subjects with a unilateral sacroiliac joint (SIJ) pain disorder (n=12). All subjects reported reduced difficulty ratings during an ASLR with pelvic compression (paired t-test: p<0.001), yet no statistically significant changes in the muscle activation or pressure variables were found. However, visual inspection of the data revealed two divergent motor control strategies with the addition of compression. Seven subjects displayed characteristics of a decreased EMG profile, while in the other five subjects the EMG profile appeared to increase. As such this study provides preliminary evidence of two disparate patterns of motor control in response to the addition of pelvic compression to an ASLR. The findings may reflect different mechanisms, not only in the response to pelvic compression, but also of the underlying PGP disorder.
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motor control patterns during an active Straight Leg Raise in chronic pelvic girdle pain subjects
Spine, 2009Co-Authors: Darren Beales, Peter Osullivan, Kathryn N BriffaAbstract:STUDY DESIGN: Repeated measures. OBJECTIVE: To investigate motor control (MC) patterns in chronic pelvic girdle pain (PGP) subjects during an active Straight Leg Raise (ASLR). SUMMARY OF BACKGROUND DATA: The ASLR is a test used to assess load transference through the pelvis. Altered MC patterns have been reported in subjects with chronic PGP during this test. These patterns may impede efficient load transfer, while having the potential to impinge on respiratory function and/or to adversely affect the control of continence. METHODS: Twelve female subjects with chronic PGP were examined. Electromyography of the anterior abdominal wall, right chest wall and the scalene, intraabdominal pressure, intrathoracic pressure, respiratory rate, pelvic floor kinematics, and downward Leg pressure of the nonlifted Leg were compared between an ASLR lifting the Leg on the affected side of the body versus the nonaffected side. RESULTS: Performing an ASLR lifting the Leg on the affected side of the body resulted in a predominant MC pattern of bracing through the abdominal wall and the chest wall. This was associated with increased baseline shift in intraabdominal pressure and depression of the pelvic floor when compared with an ASLR lifting the Leg on the nonaffected side. CONCLUSION: This MC pattern, identified during an ASLR on the affected side of the body, has the potential to be a primary mechanism driving ongoing pain and disability in chronic PGP subjects.
Andry Vleeming - One of the best experts on this subject based on the ideXlab platform.
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physical characteristics of women with severe pelvic girdle pain after pregnancy a descriptive cohort study
Spine, 2008Co-Authors: Inge Ronchetti, Andry Vleeming, Janpaul Van WingerdenAbstract:Study design Descriptive cohort study. Objective This study aims to further elucidate the differences in physical characteristics of women with severe pregnancy-related pelvic girdle pain (PGP). Summary of background data There is increasing interest in pelvic girdle pain (PGP). To our knowledge, this is the first study on a large population of patients with severe PGP, after pregnancy, based on high cutoff scores on diagnostic PGP tests. Methods Two hundred five patients were selected from the outpatient clinic of a rehabilitation center. Patients were divided in 3 inclusion groups based on the total number of positive scores on 5 diagnostic tests; i.e., active Straight Leg Raise test, posterior pelvic pain provocation test, long dorsal sacroiliac ligament test, and hip abduction and adduction strength tests. These inclusion groups were related to the data on trunk strength test, general provocation tests, Quebec Back Pain Disability Scale (QBPDS) and activities of daily living. Results A typical pattern of PGP emerges from this study. The mean group score on the active Straight Leg Raise, posterior pelvic pain provocation, and long dorsal sacroiliac ligament tests became higher when more than 3 inclusion tests were positive. Hip abduction and adduction strength became lower with more positive tests. The QBPDS score was overall high and significantly higher for 5 positive tests compared with 3 and 4 positive tests. This shows that the number of positive tests, the individual score on the diagnostic tests, and the QBPDS could all be an indicator for severity of PGP. Among the general pain provocation tests, both the passive hip flexion test and the upper and middle sacral thrust test scored high. The maximal isometric strength of trunk muscles was below the 10th percentile compared with women without complaints and was even less for 5 positive inclusion tests. It is confirmed that there is a typical order for difficulties with daily activities for PGP patients as follows (most difficult first): standing still, cycling, walking, sitting, and lying. Conclusion The study shows that the level of severity in PGP can be adequately assessed by a combination of specific tests.
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validity of the active Straight Leg Raise test for measuring disease severity in patients with posterior pelvic pain after pregnancy
Spine, 2002Co-Authors: Jan M A Mens, Andry Vleeming, Chris J Snijders, Bart W Koes, Henk J StamAbstract:STUDY DESIGN: A cross-sectional analysis was performed with a group of women meeting strict criteria for posterior pelvic pain after pregnancy. The active Straight Leg Raise test and common severity measurement scales of lumbopelvic pain were scored. OBJECTIVE: To assess the validity of the active Straight Leg Raise test as a disease severity scale for patients with posterior pelvic pain after pregnancy. SUMMARY OF BACKGROUND DATA: Various diagnostic tools are used to measure disease severity in patients with posterior pelvic pain after pregnancy, but simple tests with high reliability and validity still are needed. METHODS: The investigation was performed with 200 women who had posterior pelvic pain after pregnancy. The validity of the active Straight Leg Raise test as a severity scale was investigated by comparing the test score with the medical history, scores on self-reported disability scales, pain and tiredness, and pain provocation tests. The usefulness of the active Straight Leg Raise test as a severity scale was compared with that of the Quebec Back Pain Disability Scale. The influence of several demographic and anthropometric variables on the active Straight Leg Raise score was investigated. RESULTS: The active Straight Leg Raise score ranged from 0 to 10 and correlated as expected with all severity scales. The correlation between the scores on the active Straight Leg Raise test and the Quebec Back Pain Disability Scale was 0.70. No association was found between the active Straight Leg Raise score and age, parity, duration of the postpartum period, height, or weight. CONCLUSION: The active Straight Leg Raise test can be recommended as a disease severity scale for patients with posterior pelvic pain after pregnancy.
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reliability and validity of the active Straight Leg Raise test in posterior pelvic pain since pregnancy
Spine, 2001Co-Authors: Jan M A Mens, Andry Vleeming, Chris J Snijders, Bart W Koes, Henk J StamAbstract:Study Design. A cross-sectional analysis was performed in a group of women meeting strict criteria for posterior pelvic pain since pregnancy (PPPP). The scores on the Active Straight Leg Raise Test (ASLR test) were compared with the scores of healthy controls. Objectives. To develop a new diagnostic instrument for use in patients with PPPP. The objectives of the present study were to assess the validity and reliability of the ASLR test. Summary of Background Data. Various diagnostic tools are used to diagnose PPPP, but there is still a need for simple tests with high reliability, sensitivity, and specificity. Methods. Reliability of the ASLR test was assessed in a group of 50 women with lumbopelvic pain of various etiologies and various degrees of severity; Sensitivity was assessed in 200 patients with PPPP and specificity in 50 healthy women. Sensitivity and specificity of the ASLR test were compared with the posterior pelvic pain provocation test (PPPP test). Results. The test-retest reliability measured with Pearson's correlation coefficient between the two ASLR scores 1 week apart was 0.87. The intraclass correlation coefficient (ICC) was 0.83. Pearson's correlation coefficient between the scores of the patient and the scores of a blinded assessor was 0.78; the ICC was 0.77. In the patient group, the ASLR score ranged from 0-10; in the control group it ranged from 0-2. The best balance between specificity and sensitivity was found when scores 1-10 are designated as positive and zero as negative. With this cut-off point sensitivity of the test was 0.87 and specificity was 0.94. The sensitivity of the ASLR test is higher than the sensitivity of the PPPP test; an advantage of the ASLR test is the simplicity of measuring the score. Conclusion. The ASLR test is a suitable diagnostic instrument to discriminate between patients who are disabled by PPPP and healthy subjects. The test is easy to perform; reliability, sensitivity, and specificity are high. It seems that the integrity of the function to transfer loads between the lumbosacral spine and Legs is tested by the ASLR test.
