Double Straight Leg Lowering Test
Positioning: The patient is supine, with their hips flexed to 90 degrees and a blood pressure cuff placed under the lumbar spine in the region of L4-5. The cuff is then inflated to 40mmHg. The clinician then raises the patients legs until a noticible posterior rotation of the pelvic occurs and the patient is asked to perform an abdominal bracing procedure to precent more pelvic motion.
Test: The patient attempts to slowly lower their legs to the table maintaining the abdominal contraction. At the point where their is a fluxation in pressure as measured by the cuff or a noticible anterior pelvic rotation, the test is concluded. The amount of hip motion is measured by the clinician.
Normal (5/5): Able to reach 0-15 degrees from the table before tilting of the pelvis.
Good (4/4): Able to reach 16-45 degrees from the table for tilting of the pelvis.
Fair (3/3): Able to reach 46-75 degrees from the table before tilting of the pelvis.
Poor (2/2): Able to reach 75-90 degrees from the table before tilting of the pelvis.
O’Sullivan P, Twomey L, Allison G. Evaluation of specific stabilizing exercises in the treatment of chronic low back pain with radiologic diagnosis of spondylosis or spondylolisthesis. Spine 1997; 22:2959-2967.
Hodges P, Richardson C, Jull G. Evaluation of the relatioship between laboratory and clinical tests of transversus abdominis function. Physiother Res Int 1996;1:30-40.