{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:43:37Z","timestamp":1790876617461,"version":"4.1.0"},"reference-count":59,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T00:00:00Z","timestamp":1601078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Lumbar radiculopathy is a nerve root disorder whose correct diagnosis is essential. The objective of the present study was to analyze the reliability diagnostic validity of eight neurodynamic and\/or orthopedic tension tests using magnetic resonance imaging as the Gold Standard. Methods: An epidemiological study of randomized consecutive cases which was observational, descriptive, transversal, double blinded and was conducted following the Standards for Reporting Diagnostic accuracy studies (STARD) declaration. The sample size was 864 participants. Internal and external validity (CI = 95%) and reliability, were calculated for all tests performed independently. The diagnostic validity of the combined and multiple tests in parallel was also calculated. Results: The analysis indicated that only two tests performed independently had external validity, but neither had reliability or precision. The Straight Leg Raise test and the Bragard test performed in a multiple parallel way showed high sensitivity (97.40%), high negative predictive value (PV\u2212 96.64%) and external validity (Likelihood Ratio\u2212 0.05). The combined test of the Slump test and the Dejerine\u2019s triad had internal and external validity. Conclusions: The Straight Leg Raise test and the Bragard test performed in a multiple parallel way and the combined test of the Slump Test and the Dejerine\u2019s triad have clinical validity to discard lumbar or lumbar-sacral radiculopathy.<\/jats:p>","DOI":"10.3390\/ijerph17197046","type":"journal-article","created":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T22:24:42Z","timestamp":1601245482000},"page":"7046","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Use of Neurodynamic or Orthopedic Tension Tests for the Diagnosis of Lumbar and Lumbosacral Radiculopathies: Study of the Diagnostic Validity"],"prefix":"10.3390","volume":"17","author":[{"given":"Francisco Javier","family":"Gonz\u00e1lez Espinosa de los Monteros","sequence":"first","affiliation":[{"name":"Andalusian Health Service, Hospital \u201cPuerta Universitario del Mar\u201d, Av. Ana de Viya, 21, 11009 C\u00e1diz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5850-3055","authenticated-orcid":false,"given":"Gloria","family":"Gonzalez-Medina","sequence":"additional","affiliation":[{"name":"Nursing and Physiotherapy Department, Cadiz University, Av. Ana de Viya, 52, 11009 Cadiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4403-3029","authenticated-orcid":false,"given":"Elisa Maria Garrido","family":"Ardila","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Therapy, Medicine Faculty, Extremadura University, 06006 Badajoz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Rodr\u00edguez","family":"Mansilla","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Therapy, Medicine Faculty, Extremadura University, 06006 Badajoz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Paz","family":"Exp\u00f3sito","sequence":"additional","affiliation":[{"name":"Andalusian Health Service, Hospital \u201cPuerta Universitario del Mar\u201d, Av. Ana de Viya, 21, 11009 C\u00e1diz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petronila Oliva","family":"Ruiz","sequence":"additional","affiliation":[{"name":"Nursing and Physiotherapy Department, Cadiz University, Av. Ana de Viya, 52, 11009 Cadiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,26]]},"reference":[{"key":"ref_1","first-page":"6023","article-title":"Dolores musculoesquel\u00e9ticos. Radiculopat\u00edas. Afectaci\u00f3n de partes blandas. Artritis aguda","volume":"10","author":"Palazuelos","year":"2011","journal-title":"Medicine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.pjnns.2015.12.001","article-title":"Treatment of lumbar disc herniation with radiculopathy. Clinical practice guidelines endorsed by The Polish Society of Spinal Surgery","volume":"50","author":"Latka","year":"2016","journal-title":"Neurol Neurochir. Pol."},{"key":"ref_3","first-page":"24","article-title":"Evaluaci\u00f3n de art\u00edculos cient\u00edficos sobre pruebas diagn\u00f3sticas","volume":"3","year":"2007","journal-title":"Evid. Pediatr."},{"key":"ref_4","first-page":"42","article-title":"An\u00e1lisis de la calidad de los estudios de evaluaci\u00f3n de pruebas diagn\u00f3sticas","volume":"28","author":"Zamora","year":"2008","journal-title":"Nefrolog\u00eda"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/1471-2474-8-75","article-title":"A theoretical model for the development of a diagnosis based clinical decision rule for the management of patients with spinal pain","volume":"8","author":"Murphy","year":"2007","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1746-1340-17-9","article-title":"Pain patterns and descriptions in patients with radicular pain: Does the pain necessarily follow a specific dermatome?","volume":"17","author":"Murphy","year":"2009","journal-title":"Chiropr. Osteopat."},{"key":"ref_7","first-page":"26","article-title":"S\u00edndrome lumboci\u00e1tico","volume":"17","year":"2006","journal-title":"Rev. Med. Clin. Condes."},{"key":"ref_8","first-page":"43","article-title":"Semiolog\u00eda del dolor lumbar","volume":"16","year":"2010","journal-title":"Rev. Med. Risaralda"},{"key":"ref_9","first-page":"966","article-title":"T\u00e9cnicas cl\u00ednicas para el examen f\u00edsico neurol\u00f3gico. III. Funci\u00f3n sensitiva","volume":"39","year":"2004","journal-title":"Rev. Neurol."},{"key":"ref_10","unstructured":"Butler, D.S. (2002). Movilizaci\u00f3n del Sistema Nervioso, Paidotribo."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"184","DOI":"10.4184\/asj.2013.7.3.184","article-title":"Utility of Limited Protocol Magnetic Resonance Imaging Lumbar Spine for Nerve Root Compression in a Developing Country, Is It Accurate and Cost Effective?","volume":"7","author":"Hilal","year":"2013","journal-title":"Asian Spine J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.physio.2010.05.004","article-title":"Reliability and diagnostic validity of the slump knee bend neurodynamic test for upp.er\/mid lumbar nerve root compression: A pilot study","volume":"97","author":"Trainor","year":"2011","journal-title":"Physiotherapy"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1179\/jmt.2008.16.3.136","article-title":"Upper Limb Neural Tension and Seated Slump Tests: The false positive rate among healthy young adults without cervical or lumbar symptoms","volume":"16","author":"Davis","year":"2008","journal-title":"J. Man. Manip. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/S0211-5638(07)74454-1","article-title":"Hacia un enfoque en el diagn\u00f3stico con test neurodin\u00e1micos (tensi\u00f3n neural)","volume":"29","author":"Shacklock","year":"2007","journal-title":"Rev. Fisioter."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/1746-1340-14-26","article-title":"Accuracy of spinal orthopaedic tests: A systematic review","volume":"14","author":"Simpson","year":"2006","journal-title":"Chiropr. Osteopat."},{"key":"ref_16","unstructured":"Camino Willhuber GO, P.N. (2020). Straight Leg Raise Test. Treasure Island (FL): StatPearls Publishing, StatPearls."},{"key":"ref_17","unstructured":"Natalio Firpo, C.A. (2010). Manual de Ortopedia y Traumatolog\u00eda, Carlos Natalio Firpo. [1st ed.]."},{"key":"ref_18","unstructured":"Fransoo, P. (2003). Examen Cl\u00ednico del Paciente con Lumbalgia, Paidotribo."},{"key":"ref_19","unstructured":"Ricard, F. (2003). Tratamiento Osteop\u00e1tico de las Lumbalgias y Lumboci\u00e1ticas por Hernias Discales, M\u00e9dica Panamericana."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"13","DOI":"10.3121\/cmr.2010.862","article-title":"Josef Brudzinski and Vladimir Mikhailovich Kernig: Signs for diagnosing Meningitis","volume":"8","author":"Ward","year":"2010","journal-title":"Clin. Med. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/S0004-9514(14)60634-6","article-title":"The Slump Test: Examination and treatment","volume":"31","author":"Maitland","year":"1985","journal-title":"Aust. J. Physiother."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/bmjopen-2016-012799","article-title":"STARD 2015 guidelines for reporting diagnostic accuracy studies: Explanation and elaboration","volume":"6","author":"Cohen","year":"2016","journal-title":"BMJ Open"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"h5527","DOI":"10.1136\/bmj.h5527","article-title":"STARD 2015: An updated list of essential items for reporting diagnostic accuracy studies","volume":"351","author":"Bossuyt","year":"2015","journal-title":"BMJ"},{"key":"ref_24","unstructured":"Asociaci\u00f3n M\u00e9dica Mundial (2001). Declaraci\u00f3n de Helsinki de la Asociaci\u00f3n M\u00e9dica Mundial. Principios \u00e9ticos para las investigaciones m\u00e9dicas en seres humanos. An. Sist. Sanit. Navar., 24, 209\u2013212."},{"key":"ref_25","unstructured":"UE (2016). Reglamento (UE) 2016\/679 del Parlamento Europeo y del Consejo, de 27 de abril de 2016, Relativo a la Protecci\u00f3n de las Personas F\u00edsicas en lo que Respecta al Tratamiento de datos Personales y a la Libre Circulaci\u00f3n de estos Datos y por el que se Deroga la Directiva 95\/46\/CE (Reglamento General de Protecci\u00f3n de datos), Diario Oficial de la Uni\u00f3n Europea."},{"key":"ref_26","first-page":"36","article-title":"Dolor radicular","volume":"7","year":"2000","journal-title":"Rev. Soc. Esp. Dolor"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.jcme.2007.04.001","article-title":"Physical assessment of lower extremity radiculopathy and sciatica","volume":"6","author":"Miller","year":"2007","journal-title":"J. Chiropr. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"639","DOI":"10.4321\/S0365-66912008001100004","article-title":"Oftalmolog\u00eda basada en pruebas: Evaluaci\u00f3n cr\u00edtica de la literatura sobre pruebas diagn\u00f3sticas","volume":"83","author":"Mesa","year":"2008","journal-title":"Arch. Soc. Esp. Oftalmol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"205","DOI":"10.4067\/S0716-10182010000300004","article-title":"Uso de tests diagn\u00f3sticos en la pr\u00e1ctica cl\u00ednica (Parte 1). An\u00e1lisis de las propiedades de un test diagn\u00f3stico","volume":"27","author":"Cerda","year":"2010","journal-title":"Rev. Chil. Infect."},{"key":"ref_30","unstructured":"Rup\u00e9rez, F. (2013). Validez de los Elementos Diagn\u00f3sticos en Endometriosis. Aplicaci\u00f3n al An\u00e1lisis de Decisi\u00f3n Cl\u00ednica. [Ph.D. Thesis, Departamento de Cirug\u00eda, Ciencias M\u00e9dicas y Sociales-Universidad de Alcal\u00e1]."},{"key":"ref_31","unstructured":"(2014, May 01). Epidemiolog\u00eda General y Demograf\u00eda Sanitaria, 2010\u20132011. Open Course Ware (16633). Epidat: Pruebas Diagn\u00f3sticas. Available online: https:\/\/goo.gl\/UfAwMe."},{"key":"ref_32","unstructured":"S\u00e1nchez S\u00e1nchez, J.A. (2007). Lectura cr\u00edtica de un art\u00edculo sobre diagn\u00f3stico. Atenci\u00f3n Sanitaria Basada en la Evidencia: Su Aplicaci\u00f3n a la Pr\u00e1ctica Cl\u00ednica, Consejer\u00eda de Sanidad."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1157\/13054675","article-title":"Aplicabilidad en una comunidad (validez externa) de los estudios de prevenci\u00f3n primaria de hipercolesterolemia","volume":"32","year":"2003","journal-title":"Aten. Primaria"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.rard.2016.11.002","article-title":"Likelihood ratio (raz\u00f3n de verosimilitud): Definici\u00f3n y aplicaci\u00f3n en Radiolog\u00eda","volume":"81","year":"2017","journal-title":"Rev. Argent. Radiol."},{"key":"ref_35","first-page":"73","article-title":"Assessment of the validity and reliability of a diagnostic test","volume":"1","author":"Donis","year":"2012","journal-title":"Avan. Biomed."},{"key":"ref_36","first-page":"787","article-title":"Generalidades de las pruebas diagn\u00f3sticas, y su utilidad en la toma de decisiones m\u00e9dicas","volume":"40","year":"2011","journal-title":"Rev. Colomb. Psiquiat."},{"key":"ref_37","first-page":"1","article-title":"Evaluaci\u00f3n de la precisi\u00f3n de las pruebas diagn\u00f3sticas (1). Variables discretas","volume":"13","year":"2017","journal-title":"Evid. Pediatr."},{"key":"ref_38","first-page":"247","article-title":"Statistical methods for evaluating diagnostic test agreement and reproducibility","volume":"61","year":"2009","journal-title":"Rev. Colomb. Obstet. Ginecol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Van der Windt, D., Simons, E., Riphagen, I.I., Ammendolia, C., Verhagen, A.P., Laslett, M., Deville, W., Deyo, R.A., Bouter, L.M., and de Vet, H.C. (2011). Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain. Cochrane Database Syst. Rev., 1\u201386.","DOI":"10.1002\/14651858.CD007431.pub2"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.apmr.2007.04.016","article-title":"The sensitivity of the Seated Straight-Leg Raise Test compared with the Supine Straight-Leg Raise Test in patients presenting with Magnetic Resonance Imaging evidence of lumbar nerve root compression","volume":"88","author":"Rabin","year":"2007","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2474-14-206","article-title":"Accuracy of physical examination for chronic lumbar radiculopathy","volume":"14","author":"Iversen","year":"2013","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/BRS.0b013e3181c953cc","article-title":"The accuracy of the Physical Examination for the diagnosis of Midlumbar and Low Lumar Nerve Root Impingement","volume":"36","author":"Suri","year":"2011","journal-title":"Spine"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1093\/rheumatology\/40.4.460","article-title":"Value of the bell test and the hyperextension test for diagnosis in sciatica associated with disc herniation: Comparison with Lasegue\u2019s sign and the crossed Lasegue\u2019s sign","volume":"40","author":"Poiraudeau","year":"2001","journal-title":"Rheumatology"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/RHU.0b013e31816b2f99","article-title":"The sensitivity and specificity of the slump and the straight leg raising tests in patients with lumbar disc herniation","volume":"14","author":"Majlesi","year":"2008","journal-title":"J. Clin. Rheumatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1590\/S0482-50042010000100005","article-title":"Sinal de Cecin (Sinal \u201cX\u201d): Um aprimoramento no diagn\u00f3stico de compress\u00e3o radicular por h\u00e9rnias discais lombares","volume":"50","author":"Cecin","year":"2010","journal-title":"Rev. Bras. Reumatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.jmpt.2011.04.010","article-title":"Validity of the straight-leg raise test for patients with sciatic pain with or without lumbar pain using magnetic resonance imaging results as a reference standard","volume":"34","author":"Capra","year":"2011","journal-title":"J. Manipulative Physiol. Ther."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"215","DOI":"10.3233\/BMR-2012-0339","article-title":"The pain provocation-based Straight Leg Raise Test for diagnosis of lumbar disc herniation, lumbar radiculopathy, and\/or sciatica: A systematic review of clinical utility","volume":"25","author":"Scaia","year":"2012","journal-title":"J. Back Musculoskelet. Rehabil."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1016\/j.apmr.2017.11.006","article-title":"Accuracy of clinical tests in detecting disk herniation and nerve root compression in subjects with lumbar radicular symptoms","volume":"99","author":"Ekedahl","year":"2018","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2210","DOI":"10.1016\/j.apmr.2012.04.020","article-title":"Fingertip-to-floor test and straight leg raising test: Validity, responsiveness, and predictive value in patients with acute\/subacute low back pain","volume":"93","author":"Ekedahl","year":"2012","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1097\/00007632-200001010-00016","article-title":"Consistency of history taking and physical examination in patients with suspected lumbar nerve root involvement","volume":"25","author":"Vroomen","year":"2000","journal-title":"Spine"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.spinee.2013.08.003","article-title":"An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy","volume":"14","author":"Kreiner","year":"2014","journal-title":"Spine J."},{"key":"ref_52","first-page":"1","article-title":"Concord\u00e2ncia entre o teste de distens\u00e3o dural na posi\u00e7\u00e3o sentada (slump test) e o teste de las\u00e8gue no diagn\u00f3stico fisioterap\u00eautico de lombociatalgia","volume":"83","author":"Albert","year":"2013","journal-title":"FIEP Bull."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jcm.2017.10.004","article-title":"Sensitivity and specificity of Modified Bragard Test in patients with lumbosacral rediculopathy using electrodiagnosis as a reference standard","volume":"17","author":"Homayouni","year":"2018","journal-title":"J. Chiropr. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1007\/s004150050480","article-title":"Diagnostic value of history and physical examination in patients suspected of sciatica due to disc herniation: A systematic review","volume":"246","author":"Vroomen","year":"1999","journal-title":"J. Neurol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.berh.2005.03.004","article-title":"What diagnostic tests are useful for low back pain?","volume":"19","author":"Lurie","year":"2005","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1097\/00007632-200005010-00016","article-title":"The test of Las\u00e8gue: Systematic review of the accuracy in diagnosing herniated discs","volume":"25","author":"Bezemer","year":"2000","journal-title":"Spine"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1136\/bmj.39223.428495.BE","article-title":"Diagnosis and treatment of sciatica","volume":"334","author":"Koes","year":"2007","journal-title":"Br. Med. J."},{"key":"ref_58","first-page":"5","article-title":"Accuracy of straight leg raise and slump tests in detecting lumbar disc herniation: A pilot study","volume":"58","author":"Ntawukuriryayo","year":"2012","journal-title":"Cent. Afr. J. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"596","DOI":"10.2519\/jospt.2015.5414","article-title":"Diagnostic Accuracy of the Slump Test for Identifying Neuropathic Pain in the Lower Limb","volume":"45","author":"Urban","year":"2015","journal-title":"J. Orthop. Sport. Phys. Ther."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/19\/7046\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:13:55Z","timestamp":1760177635000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/19\/7046"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,26]]},"references-count":59,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["ijerph17197046"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17197046","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,26]]}}}