Bragard Test

 Bragard Test

What is Bragard Test?

  • Bragard Test is used to evaluate nerve root compression, differentiating a genuine Lasegue sign from a pseudo-Lasegue sign. 


How it's Performed?

  • The patient is supine.
  • The examiner grasps the patient’s heel with one hand and anterior aspect of the knee with the other.
  • The examiner slowly raises the patient’s leg, which is extended at the knee.
  • At the onset of the Lasegue sign, the examiner lowers the patient’s leg just far enough that the patient no longer feels pain.
  • The examiner then passively moves the patient’s foot into extreme dorsiflexion in this position, eliciting the typical pain caused by stretching of the sciatic nerve. 

What does a positive Bragard Test mean?

  • A positive Bragard test is evidence of nerve root compression, which may lie between L4 and S1.

Sensitivity & Specificity

  • Sensitivity: 69.3%
  • Specificity: 67.42%.

Notes

  • Dull, nonspecific pain in the posterior thigh radiating into the knee is attributable to stretching of the hamstrings and should not be assessed as a Lasegue sign.
  • A sensation of tension in the calf may be attributable to thrombosis, thrombophlebitis, or contracture of the gastrocnemius.
  • The Bragard sign can be used to test whether the patient is malingering. The sign is usually negative in malingerers.

Reference

  • NCBI
  • Clinical Tests for the Musculoskeletal 3rd Ed. Book



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