Mens Jan M A, Huis In 't Veld Yvonne H, Pool-Goudzwaard Annelies
Department Rehabilitation, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Man Ther. 2012 Aug;17(4):364-8. doi: 10.1016/j.math.2012.01.007. Epub 2012 Feb 22.
Although many properties of the Active Straight Leg Raise (ASLR) test as a diagnostic test in lumbopelvic pain (LPP) are well documented, various elements are lacking. A cross-sectional study was performed to compute sensitivity and specificity, to assess the advantages and disadvantages of various cutoff points, to analyze the relation between the ASLR test and the Posterior Pelvic Pain Provocation (PPPP) test, and to investigate the relation with confounders. Data of 110 women with LPP and 72 without LPP were available. The advantages and disadvantages of four cutoff points of ASLR, and combinations of the ASLR and PPPP, were investigated by comparing sensitivity, specificity and area under the curves (AUC) of receiver operating characteristic curves (ROC). The influence of the site of pain was analyzed by means of AUC. The relation with confounders was measured using Pearson correlation coefficients. Results show that for diagnostic use the best cutoff for the ASLR test in pregnancy is between score 0 and 1. Specificity of the ASLR test is good (88%). Sensitivity for all types of LPP during pregnancy is moderate (54%), and is larger in case of more pain and disability. When combined with the PPPP test, sensitivity of the ASLR test is larger (68%). Isolated symphyseal pain, isolated low back pain and isolated coccyx pain are not diagnosed by these two tests. The ASLR test is not influenced by age, number of previous deliveries, BMI, cause of LPP (pregnancy-related or not), the existence of urinary incontinence and/or level of fatigue.
尽管主动直腿抬高（ASLR）试验作为腰骨盆疼痛（LPP）诊断试验的许多特性已有充分记录，但仍存在各种不足之处。进行了一项横断面研究，以计算敏感性和特异性，评估各种截断点的优缺点，分析ASLR试验与骨盆后疼痛激发（PPPP）试验之间的关系，并研究与混杂因素的关系。获得了110名LPP女性和72名无LPP女性的数据。通过比较接受者操作特征曲线（ROC）的敏感性、特异性和曲线下面积（AUC），研究了ASLR四个截断点以及ASLR与PPPP组合的优缺点。通过AUC分析疼痛部位的影响。使用Pearson相关系数测量与混杂因素的关系。结果表明，在孕期诊断中，ASLR试验的最佳截断值在0分至1分之间。ASLR试验的特异性良好（88%）。孕期所有类型LPP的敏感性中等（54%），疼痛和残疾程度越高，敏感性越大。与PPPP试验联合使用时ASLR试验的敏感性更高（68%）。这两项试验无法诊断孤立的耻骨联合疼痛、孤立的下背部疼痛和孤立的尾骨疼痛。ASLR试验不受年龄、既往分娩次数、体重指数、LPP病因（是否与妊娠相关）、尿失禁的存在和/或疲劳程度的影响。
