Inter-examiner Reliability of SI Joint Palpation

Reference:Robinson HS, Brox JI, Robinson R, Bjelland E, Solem S, Telje T. The reliability of selected motion- and pain provocation tests for the sacroiliac joint. Man Ther. 2007 Feb;12(1):72-9.

The objective of the study was to assess inter-rater reliability of one palpation and six pain provocation tests for pain of sacroiliac origin on patients with and without lumbo-pelvic pain. All the subjects were examined twice on the same day by experienced manual therapists.

Percentage agreement and kappa statistic were used to evaluate the tests reliability.

Basic Result: The kappa values for palpation of segmental motion restriction were very poor and in some cases even less than chance observation (negative kappa values). However, palpation for SI pain provocation tests showed moderate to good reliability.

Conclusion: Palpation methods to find segmental motion restriction at the sacro-iliac joint are not reliable, however SI palpation methods used to provoke pain responses are more reliable.

Clinical Relevance: When you press on the sacrum better resist the temptation to judge it as hypo-mobile or asymmetrical. The best we can do is say, SI distraction test produces local SI joint pain …that’s all!

Posted on: January 19, 2012

Categories: SI & Pelvis

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