Reliability and validity of straight leg raise test in individuals with radicular pain: A scoping review

Abstract

Background

Straight Leg Raise (SLR) assessment represents a foundational neurodynamic maneuver employed for diagnosing radicular pain; however, its reliability and validity vary across populations and clinical settings. Despite frequent clinical use, inconsistencies remain in diagnostic accuracy and standardized testing methods.

Objective

This scoping review endeavored to comprehensively synthesize the Straight Leg Raise’s reliability and accuracy in individuals with radicular pain, examining psychometric properties including sensitivity, specificity, and inter-rater reliability across diverse clinical populations.

Methods

A comprehensive search of Scopus, PEDro, Cochrane Library, and PubMed (2015–2025) was conducted following PRISMA-ScR guidelines, using the PCC framework, which is Population (adults with radicular pain), Concept (reliability and validity of SLR), and Context (clinical and diagnostic settings). Studies assessing SLR reliability or validity in individuals with radicular pain were included. Data on sensitivity, specificity, reliability, and diagnostic accuracy were extracted.

Results

A total of 1247 studies screened, eight investigations fulfilled inclusion requirements after full-text appraisal, with synthesis of the evidence demonstrating that the SLR test has a low specificity (25–81%) but a high sensitivity (77–97%) for identifying lumbar nerve root involvement. Inter-rater reliability was enhanced by standardized procedures with structural differentiation (kappa up to 0.87). In older persons (>60 years, 33%), sensitivity declined. SLR’s negative predictive value and diagnostic accuracy were enhanced when combined with tests such as Bragard or slump.

Conclusion

When combined with thorough neurodynamic evaluations rather than utilised in isolation, the SLR test is a useful screening tool for radicular pain. In order to improve diagnosis accuracy across a range of clinical groups, future research should focus on standardising testing procedures, validating test combinations, and creating age-specific modifications. Open Science Framework registries (OSF) with a registration https://doi.org/10.17605/OSF.IO/N4GES.

Keywords

pain reproducibility of results predictive value of tests psychometrics leg

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