Execution
- 1Seat the patient on the table with the hips neutral, legs supported, and hands behind the back.
- 2Ask the patient to slump the thoracic and lumbar spine while maintaining the head in neutral.
- 3Maintain thoracolumbar flexion with shoulder overpressure and then asks the patient to flex the cervical spine.
- 4Hold the foot in dorsiflexion and ask the patient to extend the knee as far as possible.
- 5Release cervical flexion to see whether symptoms decrease or knee extension increases.
Positive outcome
The test is positive when the patient’s familiar pathological symptoms are reproduced and are changed by releasing cervical flexion or another sensitizing component. Normal responses can include symmetrical hamstring or posterior knee discomfort, T8-T9 discomfort, and symmetrical restriction of knee extension or ankle dorsiflexion. Magee emphasizes reproduction of the patient’s symptoms, not just production of stretch discomfort.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Majlesi et al. (2008) | NA | 84 | 83 | 4.94 | 0.19 |
| Ekedahl et al. (2018) | NA | 78-100 | 36-55 | NA | NA |
CommentMagee presents the slump test as the most common lower-limb neurological test and stresses the importance of sensitizing and desensitizing components. Majlesi found higher sensitivity for slump than SLR in MRI-confirmed lumbar disc herniation, but performance varies by pathology definition and reference standard. It is useful when symptoms are low-irritability or when SLR is negative but radicular features remain plausible.
Moderate Clinical Value