Können Physiotherapeuten klinisch relevante Veränderungen des Straight-Leg-Raise-Tests bei Probanden mit subakuten/akuten Beschwerden feststellen?

Zusammenfassung

Hintergrund: Der Straight-Leg-Raise-Test (SLR) dient klinisch häufig zum Wiederbefund. Der kleinste klinisch relevante Unterschied (Minimal clinically important change, MCIC) und die Änderungssensitivität sind unbekannt.

Ziel: Diese longitudinale multizentrische Studie untersuchte den MCIC und die Änderungssensitivität für den Straight-Leg-Raise bei Patienten mit subakuten/akuten unteren Rückenschmerzen (LBP) und/oder unilateralen Beinschmerzen.

Methode: Bei den eingeschlossenen 10 Probanden mit ausstrahlenden LBP wurden zu 2 Zeitpunkten (t1; t2) der SLR beidseitig mit/ohne Dorsalextension, der LBP sowie die unilateralen Beinschmerzen und die Aktivitätseinschränkung gemessen. Zu t2 wurden die subjektive Veränderung des Gesundheitszustands mittels der Global Rating of Change Scale (GROC) und Korrelationen zwischen den Veränderungen im SLR und der genannten Parameter ermittelt. Mithilfe der Area under the Curve (AUC) und der Korrelationen wurden die Änderungssensitivität und die Schwellenwerte für den SLR berechnet.

Ergebnisse: Die Veränderung des LBP zeigte gute bis sehr gute Korrelationen mit dem SLR mit/ohne Dorsalextension. Die AUC mit LBP als Anker erreichte im SLR einen fast akzeptablen Wert. Der dazugehörige Schwellenwert lag bei 17°.

Schlussfolgerung: Die zu kleine Stichprobengröße ließ keine präzisen Aussagen zu. Es gibt jedoch Hinweise, dass der SLR als änderungssensitiv für die Konstrukte unilaterale Beinschmerzen und LBP gelten könnte.

Abstract

Background: The straight leg raise test is clinically often used for reassessment. The minimum clinically important change (MCIC) and the sensitivity to change are unknown.

Objective: This longitudinal multicentre study investigated the MCIC and the sensitivity to change for the SLR in patients with subacute/acute low back pain (LBP) and/or unilateral leg pain.

Method: At 2 points in time (t1; t2) the bilateral SLR with/without dorsal extension, the LBP as well as the unilateral leg pain and the restriction of activity were assessed in the included 10 subjects with radiating LBP. At t2 the subjective change of physical health state was measured using the global rating of change scale (GROC). Correlations between SLR changes and the mentioned parameters were assessed. The SLR’s sensitivity to change and threshold levels were calculated using the area under the curve (AUC).

Results: SLR change showed good to very good correlations with SLR with/without dorsal extension. AUC with LBP as anchor produced an almost acceptable performance. The corresponding threshold level was 17°.

Conclusions: The too small sample allowed no concise statement. There exists, however, an indication that the SLR might be considered to be sensitive to change for unilateral leg pain constructs.

Schlüsselwörter

Straight-Leg-Raise-Test (SLR) - Änderungssensitivität - kleinster klinisch relevanter Unterschied (MCIC)

Key words

straight leg raise test (SLR) - sensitivity to change - minimum clinically important change (MCIC)

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