Spine Orthopaedic Test: Leg Lowering Test

The Leg Lowering Test, is a physical examination technique used to assess the function of the core muscles, particularly the lower abdominals and hip flexors. Here's a step-by-step procedure for performing the test:

1. The patient lies flat on their back on an examination table with their legs straight out and their arms by their sides.
2. The examiner instructs the patient to lift both legs off the table, keeping them straight and together.
3. The examiner observes the patient's legs to ensure they are lifted to an appropriate height and held steady.
4. The examiner then instructs the patient to slowly lower one leg down towards the table, while keeping the other leg in the lifted position.
5. The examiner observes the patient's movements and notes any compensations, such as tilting the pelvis or lifting the opposite leg off the table.
6. The patient then raises the lowered leg back to the starting position and repeats the test on the other side.

The test can be made more challenging by lowering the legs further towards the table, or by adding resistance (e.g. by placing a weight on the patient's ankles). The test can also be modified to specifically target the transverse abdominis muscle by asking the patient to draw their belly button in towards their spine while performing the test.

References:

1. Storheim, K., Holm, I., Gunderson, R., & Brox, J. I. (2003). The effect of comprehensive group training on cross-sectional area, density, and strength of paraspinal muscles in patients sick-listed for subacute low back pain. Journal of Spinal Disorders & Techniques, 16(3), 271-279.
2. Kiesel, K. B., Plisky, P. J., & Voight, M. L. (2007). Can serious injury in professional football be predicted by a preseason functional movement screen? North American journal of sports physical therapy, 2(3), 147.
3. Boren, K., Conrey, C., Le Coguic, J., Paprocki, L., & Voight, M. (2009). The influence of core muscle activation on dynamic trunk position and knee abduction moments: implications for ACL injury. Journal of Athletic Training, 44(4), 435-441.
4. Comerford, M., & Mottram, S. (2001). Functional stability re-training: principles and strategies for managing mechanical dysfunction. Manual therapy, 6(1), 3-14.