Mousavi, SJ; Department of physical therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. MOUSAVI@REHAB.MUI.AC.IR.

PURPOSE: The purpose of this study was to determine the inter examiner and intra examiner reliability of eight sacroiliac joint static and dynamic palpation tests used to diagnose sacroiliac joint dysfunction. SUBJECTS: Ten patients with low back pain ranging in age 25-40 years. METHODS AND MATERIALS: Three motion palpation tests, 1) the Gillet test, 2) the standing flexion test, and 3) the sitting flexion test and five static palpation tests, namely palpation and assessment of the levels of the 1) posterior superior iliac spine (PSIS) in standing position, 2) PSIS in sitting position, 3) anterior superior iliac spine (ASIS) in standing position, 4) Medial Maleolus (MM) in supine position, and 5) MM in long sitting position were performed on ten subjects by four examiners. Each test was performed four times by each examiner resulting in 1280 assessments in total. ANALYSES: Reliability was determined using Kappa Statistic which allows assessment of observer agreement for more than two examiners and multiple examinations. RESULTS: Intra examiner agreement of static palpation tests revealed a range of reliability from slight to good. Kappa coefficient yielded intra examiner agreement that ranged between slight to good for the PSIS in standing position (0.18-0.75), slight to moderate for the ASIS (0.15-0.5), and slight to fair (0.1-0.35) for other static and all motion palpation tests. Inter examiner reliability of all the static and dynamic tests did not exceed slight reliability (0.0-0.2). CONCLUSIONS: The results of this study suggest that the reliability of palpation and assessment of the levels of the PSIS, ASIS, and MM in static positions, and the Gillet, standing flexion, and siting flexion tests as indicators of sacroiliac joint dysfunction still remain questionable. Therapists should reconsider the usefulness of evaluation techniques that rely on the assessment of the anatomical symmetry of bony landmarks of the innominates in static and dynamic conditions. FUNDING: Research center, Isfahan University of Medical Sciences.

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