Bragard’s Test
If your patient is complaining about pain in their lower back and lower extremities, then conduct the Bragard’s Test to assess if the pain has something to do with nerve root compression!
Fact Checked by RJ Gumban.
What is the Bragard Test?
The Bragard Test, also known as Bragard’s Test or Bragard’s Sign, is a type of physical examination technique developed to gauge patients experiencing pain in their lower back and lower extremities. It specifically assesses if a patient’s lower back pain is caused by nerve root compression or irritation.
This particular physical examination technique requires the patient to lie down face up on a bed. The healthcare professional conducting the test will then move one of the patient’s legs upward and dorsiflex their foot to see if they will experience pain. If they do experience pain during this exercise, then there is a chance that the patient is dealing with lumbar radiculopathy.
Lumbar radiculopathy is characterized by pain, weakness, and/or numbness in the lower back or legs due to nerve root compression. The Bragard Test will help determine if the patient possibly has this condition; other lumbar-related tests and imaging tests can help confirm or refute the suspicion based on the results.
While the test is reliable in determining the possibility of this problem, it doesn’t confirm it. Other tests can help with confirming it. More on that later on in this guide.
Have a look at this video if you want to see how the Bragard's Test is performed:
Printable Bragard’s Test
Download this Bragard’s Test to assess lower back pain in your patients.
How to perform the Bragard’s Test
Now that you know what the Bragard Test aims to do, it’s time to expound on what the healthcare professional conducting it needs to do to perform this test successfully.
Before anything, you should know that the Bragard Test requires only one thing besides your hands. You only need a comfortable examination bed or table for your patient to lie down on.
Once the examination bed is ready, have your patient lie on it supine (they must be facing up). Make sure that their legs are straightened as well.
As for you, you need to position yourself on the side of the patient, specifically by the legs. When you’re in position, you will do the following:
- You will lift the patient’s leg while keeping it straight.
- You will lift the leg slowly into hip flexion. As you are lifting the leg, tell the patient to tell you if they feel any pain or discomfort at any point while you lift the leg.
- Stop lifting the leg once the patient notifies you of any pain or discomfort.
- Lower the leg a bit. Five degrees should suffice.
- Next, it’s time for passive ankle dorsiflexion. Dorsiflex (bend) the ankle backward. Make sure it’s dorsiflexed firmly.
The Bragard Test is easy! These instructions should be enough to help you conduct it properly.
How to interpret the results of the Bragard’s Test
The instructions of the Bragard Test are easy to follow. Still, the most important part of the test is determining the possibility of lumbar radiculopathy in the patient’s lower back region.
You can make that assessment when you dorsiflex the ankle backward. Before that, the patient supposedly experienced pain or discomfort while lifting their leg, and then you lower the leg a bit (again, five degrees from the point of pain should be good).
If dorsiflexing their ankle backward reproduces the pain they felt earlier, then the test is positive. If the pain seems to be coming from the hip, then you know there is nerve root compression in the lumbar area, which is a sign that they might have lumbar radiculopathy. Again, make sure the ankle is dorsiflexed firmly.
If the patient doesn’t feel anything, they are negative.
If they are positive, the best action is to endorse them for a more comprehensive examination. If they are already undergoing a comprehensive examination, pass them on to the next person conducting another test if it’s not you. Share the results with them so they know what to consider and what they should do.
Bragard’s Test Example
Since the Bragard Test is a physical examination technique, it normally doesn’t have a sheet to record any findings. That’s why we at Carepatron made a sheet template for it! Our Bragard Test template includes instructions and what to consider when designating the patient as positive or negative.
It has checkboxes for you to make a designation and an additional comments box to discuss your findings, decisions, and reasoning behind those decisions. Here is what it looks like:
Download this Bragard’s Test Example (Sample) here:
If you like what you see and think this will help you better understand your patient, feel free to download our template! It won’t cost you a thing. You can fill it out with a pen if you like filling physical sheets, or you can go paperless and just fill out the PDF!
When is it best to conduct the Bragard’s Test?
The best time to conduct the Bragard Test is when a patient attends an appointment with you and discusses pains in their lower back and/or lower extremities. Suppose the patient has no pre-existing conditions based on their medical history. In that case, conducting this test as early as possible is a must so that you can have the opportunity to identify the possibility of particular problems, confirm it with other tests, and then proceed to find ways to provide early intervention and treatment!
Now, one of the points we made earlier is to endorse the patient for further examination if the Bragard Test results in a positive designation. This is because the test should not be the sole assessment to confirm that the patient has lumbar radiculopathy or other lower back problems. It simply identifies the possibility of the condition, not confirm it.
Other tests, like electrodiagnostic tests, can help build a case for it if the results are consistent and may even detect other problems the patient might have. Imaging tests like MRI can confirm all the suspicions that come up as part of all the other tests, and then the proper diagnoses can be made.
What are the benefits of the Bragard’s Test?
It won’t take up much of the professionals' and the patients' time.
The Bragard Test is one of the easiest physical examination techniques to perform. Healthcare professionals who use this can finish in a minute or two because the instructions are straightforward. It also guarantees immediate results because you can find out if the patient is positive as soon as you can replicate the pain that a patient felt before you dorsiflex the ankle backward.
The test is also inexpensive because you only need a comfortable examination bed.
It can help determine what exactly the problem is.
The Bragard Test will help professionals determine if the lower back pain that a patient is feeling is due to a nerve root irritation or compression. While it doesn’t specifically confirm the problem, it can at least identify that it is caused by compression or irritation.
Other tests can confirm which specific nerve root is compressed or irritated, and by confirming the specific nerve root, they can determine the actual problem. Is it lumbar radiculopathy or some other condition like lumbar spinal stenosis, degenerative disc disease, or disc herniation? You’ll find out by conducting other tests.
It can be used to check if the patient has recovered.
The Bragard Test doesn’t have to be a one-time, big-time thing. Let’s stipulate that your patient was diagnosed with lumbar radiculopathy, and your team developed and implemented a treatment plan. At a certain point, you will be conducting a routine check-up to see how they’re doing.
You can repeat this test to see if the pain is still present when you raise the leg and dorsiflex the ankle. If they don’t feel pain anymore, the treatment succeeds. Hopefully, it won't hurt as much if it’s still there. But if the pain is still there, you might need to adjust the treatment plan and see if the adjustments will work.
Why use Carepatron for physical therapy-related work?
Carepatron houses a massive repository of clinical resources. From worksheets to assessments and survey templates to general treatment plan templates, you will find many resources that can benefit you and your team, especially regarding physical therapy!
If you take your time to browse around, you will eventually stumble upon other templates for clinical provocative tests and physical examination techniques besides the Bragard Test. Keep in mind our point that this should be part of a comprehensive examination! If you’re looking for other assessments for physical therapists to include in a comprehensive examination, Carepatron is the best place to look for more tests! Don’t be shy and download as much as you want and need for free! If the resources we have can help you get a better picture of your patient, then we’re happy!
Besides our resource repository, we also have a storage system that will allow you to store your clinical documents in a HIPAA-compliant manner! If you downloaded our Bragard Test template, you can store filled-out versions with us! Doing so will create electronic backups of your files, so just in case you somehow lose your physical copies, you can redownload and reprint them.
You can even determine who gets to access these files besides you, so we recommend that you have your whole team use our platform and storage system so you can store all your files and share results more efficiently!
We at Carepatron are all about helping healthcare professionals with their work, so take advantage of our platform so we can help streamline your workflows and help you preserve your work!
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Commonly asked questions
The test is straightforward and easy to do, and you can accomplish this in a minute or two. Though, take your time! You want the results to be as accurate as possible.
Yes. It wouldn’t be included in a comprehensive examination if it was unreliable. While it doesn’t confirm specific problems, it can be used to determine if a nerve root irritation or compression causes the pain. Other tests can be used to determine the specific nerve root and diagnose the appropriate problem.
That depends. The test relies on pain for the professional to make a designation, so the Bragard Test is painful. But whatever pain or discomfort a patient feels during this test is caused by the lower back pain they already have in the first place.
