Reliability and validity of the active straight leg raise test in posterior pelvic pain since pregnancy

Study Design. A cross-sectional analysis was performed in a group of women meeting strict criteria for posterior pelvic pain since pregnancy (PPPP). T he scores on the Active Straight Leg Raise Test (ASLR test) were compared w ith 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 P PPP, but there is still a need for simple tests with high reliability, sens itivity, and specificity. Methods. Reliability of the ASLR test was assessed in a group of 50 women w ith lumbopelvic pain of various etiologies and various degrees of severity. Sensitivity was assessed in 200 patients with PPPP and specificity in 50 h ealthy women. Sensitivity and specificity of the ASLR test were compared wi th the posterior pelvic pain provocation test (PPPP test). Results. The test-retest reliability measured with Pearson's correlation co efficient 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 speci ficity and sensitivity was found when scores 1-10 are designated as positiv e 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 discrimina te 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 lum bosacral spine and legs is tested by the ASLR test.