Evaluation of the presence of sacroiliac joint region dysfunction using a combination of tests: a multicenter intertester reliability study.
OBJECTIVE
The authors examined the intertester reliability of assessments made based on a composite of 4 tests of pelvic symmetry or sacroiliac joint (SIJ) movement that are advocated in the literature for identifying people with SIJ region dysfunction. "Sacroiliac joint region dysfunction" is a term used to describe pain in or around the region of the joint that is presumed to be due to malalignment or abnormal movement of the SIJs.


METHODS
Sixty-five patients with low back pain and unilateral buttock pain were seen in 1 of 11 outpatient clinics.


METHODS
Thirty-four therapists, randomly paired for each subject, served as examiners. Kappa coefficients and observed proportions of positive (Ppos) and negative (Pneg) agreement were calculated to estimate reliability.


RESULTS
For the composite test results, percentages of agreement ranged from 60% to 69%, kappa coefficients varied from.11 to.23, and Ppos was lower than 50%.


CONCLUSIONS
Reliability of measurements obtained with the 4 tests appears to be too low for clinical use. Given the measurement error found in this study, the authors suspect it is likely that either the proper treatment technique will not be chosen based on the test results or the intervention will be applied to the wrong side. The 4 tests probably should not be used to examine patients suspected of having SIJ region dysfunction, although the role of therapist training in use of the procedures is unclear.
Riddle
Daniel L
DL
Department of Physical Therapy, Medical College of Virginia Campus, Virginia Commonwealth University, 1200 E Broad St, Richmond, VA 23298-0224, USA. driddle@hsc.vcu.edu
Freburger
Janet K
JK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010147:Pain Measurement / Q000379:methods / Q000592:standards*; D010808:Physical Examination / Q000379:methods / Q000592:standards*; D015203:Reproducibility of Results; D012107:Research Design; D012446:Sacroiliac Joint / Q000503:physiopathology; D014481:United States