Lower Limb Neurodynamics

Question 1

Straight Leg Raise (Lasegue) - Use, Movement, Sensitizing and Differentiating Manoeuvres and Sensitivity/Specificity

Answer 1

Testing mechanosensitivity (gain of function) of lumbosacral neural structures.
Hip flexion + Knee extension.
Sensitizing manoeuvre:
- Dorsiflexion: sciatic nerve
- Dorsiflexion + eversion: tibial nerve
- Plantarflexion + inversion: peroneal
- Add. + IR: superior and inferior gluteal nerves.
Differentiation manoeuvre: neck flexion.
Sensitive.

Question 2

Slump Test - Movement, Sensitizing and Differentiating Manoeuvres and Sensitivity/Specificity

Answer 2

Trunk in slumped position.
Cervical flexion with overpressure.
Knee extension.
Ankle dorsiflexion + overpressure.
Differentiation manoeuvre: cervical extension. Positive if symptoms ease.
Sensitive.

Question 3

Prone Knee Bend Test - Movement, Sensitizing and Differentiating Manoeuvres and Structure

Answer 3

Prone with head turned towards therapist.
Take ankle and move knee into flexion. Stabilize pelvis with other hand for no hip movement.
No differentiation. Reproduction of symptoms.
Femoral nerve.

Question 4

Slump Knee Bend Test - Use, Movement, Sensitizing and Differentiating Manoeuvres and Sensitivity/Specificity

Answer 4

Useful to evoke symptoms in middle and upper lumbar radiculopathy.
Side lying.
Slump position and flexed neck.
Patient holding inferior knee close to chest.
Holding under the knee of superior leg and the foot between trunk and elbow.
Stabilising the pelvis (greater trochanter) and moving into hip extension.
Differentiation manoeuvre: neck extension -> positive if symptoms ease.