Execution
- 1Position the patient prone and relaxed.
- 2Grasp both lower extremities.
- 3Passively lift and extend both legs together to approximately 30 cm from the table.
- 4Gently pull the legs cephalad while maintaining the extended position.
- 5Lower the legs and confirm whether symptoms disappear.
Positive outcome
The test is positive when the patient reports strong lumbar pain, a very heavy feeling in the low back, or a sensation that the low back is coming off the table during the lifted position. Symptoms should disappear when the legs are lowered. Numbness or prickling alone is not considered a positive sign in Magee’s description.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Kasai et al. (2006) | NA | 84.2 | 90.4 | 8.77 | 0.17 |
| Alqarni et al. (2011) — systematic review | NA | 84 | 90 | 8.8 | 0.18 |
CommentPassive lumbar extension has the strongest diagnostic-accuracy numbers among common clinical tests for radiographic lumbar instability, but the LR+ remains below 10 and later reviews note limited replication. Magee’s positive criteria are symptom-specific and exclude numbness / prickling alone. Use the test cautiously in highly irritable extension-sensitive patients.
Moderate Clinical Value