Bragard test: procedure and interpretation (positive test)

bragard test

Named after German orthopedic physician Karl Braggard, le Bragard test is used by healthcare professionals to assess whether low back pain and/or type sciatica of the patient come from a radiculopathy lumbosacral.

Procedure

  • The patient is positioned in the supine position (lying on the back)
  • The examiner passively raises the extended leg so as to bring the hip into flexion (while maintaining the knee in full extension). It's about Lasegue test. Stop raising the leg when the patient complains of pain (a Lasègue sign positive typically occurs between 40 and 60 degrees of hip flexion).
  • Then the leg is passively lowered by the assessor to just below the pain threshold. The foot is then brought into dorsiflexion (bringing the toes towards the tibia) and it is observed whether there is a painful reaction from the patient.

Performance

The Bragard test is qualified as positive if the pain reappears when the foot is passively brought into dorsiflexion while the leg is lowered (compared to the appearance of characteristic pain during the Lasègue sign).

This would indicate nerve involvement in the origin of the patient's pain. Often it can be a radiculopathy caused by a herniated disc L4-L5 or L5-S1.

The healthcare professional can then prescribe tests formedical imaging to clarify the diagnosis (MRI, scanner, etc.). This is all the more true if theneurological clinical examination suggests disc involvement, and whether the treatment approaches attempted so far have not yielded satisfactory results.

References

  • https://www.physio-pedia.com/Bragard%27s_Sign
  • https://www.orthofixar.com/special-test/bragard-test/
  • https://www.sciencedirect.com/science/article/abs/pii/S1169833020301344
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