Rafael P. Ribeiro, PT
Journal of Manipulative and Physiological Therapeutics
Published: April 22, 2021
DOI:https://doi.org/10.1016/j.jmpt.2021.01.001
Abstract
Objective
The primary objective of this review was to investigate the reliability and validity of palpatory clinical tests of sacroiliac mobility. The secondary objective was to investigate which palpatory clinical tests of sacroiliac mobility exist in the literature.
Methods
PubMed, Embase, Scopus, Medline, and the Physiotherapy Evidence Database were searched. There was no restriction on the study design or participants. The data extracted from each study were sample size, study deign, and clinical test used. If there was information on reliability values, number of examiners, concurrent validity values, gold standard used, or inferential statistical test used, that was also extracted. For intraexaminer reliability, the data were expressed as κ values that were meta-analyzed using random effects.
Results
Fifteen palpatory clinical tests of sacroiliac mobility were identified from 28 studies; 14 studies performed inferential statistical analysis, all including analysis of interexaminer reliability, with κ values ranging from −0.05 to 0.77. Analysis of intraexaminer reliability was performed in 8 studies, with κ values ranging from 0.08 to 0.73. No study included in this systematic review verified the concurrent validity of the tests. Our meta-analysis of intraexaminer reliability showed moderate to good agreement results for the Gillet test (κ = 0.46), the standing flexion test (κ = 0.61), and the sitting flexion test (κ = 0.68).
Conclusion
We found 15 palpatory clinical tests of sacroiliac mobility in this systematic review. According to our meta-analysis, only the sitting flexion test obtained a good and statistically significant intraexaminer agreement. Further studies are necessary to evaluate the reliability and validity of these tests.
From Osteopathic Physicians and Surgeons of Oregon
The Seated Flexion Test is performed by having the patient sit on a level, low stool with feet flat on the floor, with the knees bent 90 degrees, and the feet shoulder-width apart. When the patient is asked to bend forward, he is asked to place his flexed elbows between his legs, and the operator monitors the PSIS to see if one side moves more cephalad than the other.