Execution
- 1Position the patient standing.
- 2Place the symptomatic leg on a support in front of the patient with the hip flexed and knee extended.
- 3Ask the patient to keep the knee straight.
- 4Ask the patient to bend the trunk forward over the elevated leg.
- 5Record whether familiar proximal hamstring or ischial pain is reproduced.
Positive outcome
Reproduction of familiar pain at the ischial tuberosity or proximal posterior thigh is positive. The test loads the proximal hamstring in a lengthened position. General hamstring stretch alone is not a positive test.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Cacchio et al. (2012) | ICC 0.82-0.88 across three tests | 76 | 82 | 4.22 | 0.29 |
CommentThe Puranen-Orava test has moderate diagnostic value for chronic proximal hamstring tendinopathy in athletic populations. It is more functional than the passive bent-knee stretch tests but can be influenced by neural mechanosensitivity and lumbar flexion tolerance. Use familiar ischial pain as the key criterion.
Moderate Clinical Value