title: Inter-examiner reliability of four static palpation tests used for assessing pelvic dysfunction.
abstract: In muscle energy technique (MET), palpation is an important tool aimed at detecting asymmetry and selecting interventions. The aim of this study was to test the inter-examiner reliability of static palpation of the transverse processes of L5 (L5), sacral sulci (SS), inferior lateral angles of the sacrum (ILA), and the medial malleoli (MM) in a clinical setting. Twenty-five participants, aged 18-78 years, with low back pain and/or sacroiliac pain with or without radiating pain to the knee, were independently examined by two experienced physiotherapists. For L5, SS, ILA, the proportion of observed agreement was 40-44% and the kappa coefficient 0.11 (SE=0.12) to 0.17 (SE=0.10). For MM, the observed agreement was 52% and the kappa coefficient 0.28 (SE=0.15). Differences in palpation technique seem to be the most likely source of the low inter-examiner reliability in this study. For clinical practise, continued use of these tests as methods for detecting asymmetry and selecting interventions is of doubtful utility.
authors.affiliation: Department of Community Medicine and Rehabilitation, Physiotherapy Umeå University, Umeå, Sweden. ulrika.holmgren@vll.se
authors.forename: Ulrika
authors.initials: U
authors.lastname: Holmgren
authors.forename: Kerstin
authors.initials: K
authors.lastname: Waling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis*; D017116:Low Back Pain / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010173:Palpation / Q000379:methods*; D010384:Pelvic Bones; D015203:Reproducibility of Results; D012446:Sacroiliac Joint