L5: Great Toe Extension/Extensor Hallucis Longus

Execution:

1. Patient is in supine lying position
2. The patient is asked to extend his big toe while the examiner gives resistance

 

Positive Outcome: Decreased strength rated with the MRC scale compared to the other side

Study	Reliability	Sn	Sp	LR+	LR-
Iversen et al. (2013)	NA	33	83	1.91	0.81
Hancock et al. (2011): L4/L5 Disc Herniation	NA	54	64	1.5	0.72
Hancock et al. (2011): L5/S1 Disc Herniation	NA	38	47	0.72	1.32
Comment: Extensor hallucis weakness does not seem to be able to identify a specific level of lumbar disc herniation