Yeoman Test | Sacroiliitis Examination | SIJ assessment
Patients with pelvic-girdle pain often report difficulties to transfer load between the lower limb and the trunk. The active straight leg raise test, abbreviated as ASLR is thought to test this ability. Mens et al. (2001)evaluated the test regarding its test-retest reliability and validity to discriminate healthy subjects from patients with posterior pelvic pain since pregnancy. They found a test-retest reliability after 1 week of 0.87, a sensitivity of 87%, and a specificity of 94%. For this reason, the ASLR has a high clinical value in practice.
To perform the test, have your patient lie on the bench in supine position with straight legs relaxed in lateral rotation and feet 20cm apart. Then the patient is asked to try to raise her legs one after the other above the couch for 5cm without bending the knee.
If the test is painful, the examiner repeats the test with compression of both anterior superior iliac spines or with a sacroiliac belt around the pelvis. If the movement is no longer painful, the test is scored positive.
O’Sullivan et al. from the year 2007 suggest that the ASLR might be helpful in order to distinguish patients with pelvic girdle pain and reduced force closure of the SI joint from patients with pelvic-girdle pain due to excessive force closure. In the latter group, patients usually have a negative outcome, while compression in the second step of the test might actually be provoking.
Different scores from 0-5 on both sides have been used for this test with 0 indicating no difficulties at all and 5 the inability to lift the leg on one side. While different cut-off points for this test have been discussed, the validity seems to be the highest if no effort, thus a summed score of 0, is scored as negative and 1-10 are all scored positive.
Furthermore, Mens et al in 1999 examined a strong correlation between the test scores and with mobility of the pelvic joints in patients with peripartum pelvic girdle pain. On top of that, the same authors in 2002 found that the active straight leg raise test can be recommended as a disease severity scale for patients with posterior pelvic pain after pregnancy. This is due to the fact that scores from the test from 0 to 10 correlated strongly with the degree of disability on the Quebec Back Pain Disability Scale.
At last, Mens et al. (2017) have shown that the TrA shows excessive contraction during the ASLR in patients with long-lasting pregnancy-related posterior pelvic girdle pain. This implies that there is no rationale for the prescription of exercises to enhance the contraction of TrA in patients with long-lasting pregnancy-related PGP, so another nail in the coffin for the core stability myth.
Other common orthopedic tests that aim to provoke the sacroiliac joint are:
- Distraction Test
- Sacral Thrust Test
- Gaenslen’s Test
- Sacroiliac Compression Test
- Cluster of Laslett
- Cluster of van der Wurff
Mens, J., & Pool-Goudzwaard, A. (2017). The transverse abdominal muscle is excessively active during active straight leg raising in pregnancy-related posterior pelvic girdle pain: an observational study. BMC musculoskeletal disorders, 18(1), 1-7.
Mens, J. M., Vleeming, A., Snijders, C. J., Koes, B. W., & Stam, H. J. (2002). Validity of the active straight leg raise test for measuring disease severity in patients with posterior pelvic pain after pregnancy. Spine, 27(2), 196-200.
Mens, J. M., Vleeming, A., Snijders, C. J., Koes, B. W., & Stam, H. J. (2001). Reliability and validity of the active straight leg raise test in posterior pelvic pain since pregnancy. Spine, 26(10), 1167-1171.
- Verena Fric25/11/22Orthopedic Physiotherapy of the Spine GREAT COURSE ABOUT THE SPINE
great course, best overview about the different syndromes of the spine, very helpful and relevant for the work with patientsPeter Walsh01/09/22Orthopedic Physiotherapy of the Spine 5 starsChristoph21/12/21Orthopedic Physiotherapy of the Spine Really a well done course, using the modern ways of teaching. Compliments! Sometimes for me you entered too much into details instead of touching more important chapters of Spine treatment like techniques for the treatment of muscles and fascias
- John09/10/21Orthopedic Physiotherapy of the Spine EXCELLENT COURSE HIGHLY RECOMMEND
As a newly graduated physiotherapist i highly recommend this course just to know you are on the right track with your patients. the information presented is very clear and easy to follow as well as the great physiotherapy style videos. It makes learning actually fun , thanks guys for all your hard work. Well deserved.Alexander Bender06/09/21Orthopedic Physiotherapy of the Spine During the corona crisis, I booked many online courses and webinars, but none were as entertaining and well thought out as PhysioTutors’ courses.
All units are well summarized, meaningfully broken down and easy to understand.
I am looking forward to the other courses.
Many greetings from Germany.GHADEER05/01/21Orthopedic Physiotherapy of the Spine VERY INFORMATIVE AND UPDATED
for anyone who is lost in handling spine cases, this course is very helpful.
- MICHAEL PROESMANS20/12/20Orthopedic Physiotherapy of the Spine HIGHLY METHODICAL, WITH PLENTY OF SCIENTIFIC REFERENCE
Clear, structured and well researched course concerning most common pathologies of the spinal complex.
Plenty of informative modules, with detailed video-analysis.
If you’re looking for a course to study in your own time, with enough depth and scientific background, then you’ve found a very good one here.
Bang for buck, a great course.BENOIT08/05/20Orthopedic Physiotherapy of the Spine After finishing the Orthopedic course for Lower & Upper limbs, I was looking forward to begin this Spine specific course.
Really good overview about all spine pathologies from epidemiology to diagnosis & treatment which made me more confident to care for my future patients.
ANOTHER GREAT COURSE !
The courses are well detailed with lot of informations and videos.
For me these 2 courses are must to see to learn and update knowledge for most common pathologies in Physiotherapy.Nicolas Cardon27/04/20Orthopedic Physiotherapy of the Spine This is a very interesting course !
We can find many informations about the main pathologies and their differential diagnosis and about objective and subjective exam. Videos are clear and well designed.
It’s a very well course for these who wish complete their Orthopedic Manual Therapy curriculum.
A French Physio’