Inter- and intra-examiner reliability of single and composites of selected motion palpation and pain provocation tests for sacroiliac joint (original) (raw)

Abstract

The sacroiliac joint (SIJ) has been implicated as a potential source of low back and buttock pain. Several types of motion palpation and provocation tests are used to examine the SIJ. It has been suggested that use of a cluster of motion palpation or provocation tests is a more acceptable method than single test to assess SIJ. This study examined the inter-and intra-examiner reliability of single and composites of the motion palpation and provocation tests together. Twenty-five patients between the ages of 20 and 65 years participated. Four motion palpation and three provocation tests were examined three times on both sides (left, right) by two examiners. Kappa coefficient and prevalence-adjusted and bias-adjusted kappa (PABAK) were calculated to evaluate the reliability. PABAK for intra-and inter-examiner reliability of individual tests ranged from 0.36 to 0.84 (95% CI: À0.22 to 1.12) and 0.52 to 0.84 (95% CI: À0.18 to 1.08) which is considered fair to substantial. PABAK for intra-and inter-examiner reliability for clusters of motion palpation or provocation tests ranged from 0.44 to 0.92 (95% CI: À0.36 to 1.2) which is considered moderate to excellent reliability. PABAK for intra-and inter-examiner reliability of composites of motion palpation and provocation tests ranged from 0.44 to 1.00 (95% CI: À0.22 to 1.12) and 0.52 to 0.92 (95% CI: À0.02 to 1.32) which is considered substantial to excellent. It seems that composites of motion palpation and provocation tests together have reliability sufficiently high for use in clinical assessment of the SIJ.

Key takeaways

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  1. Composites of motion palpation and provocation tests show substantial to excellent reliability for SIJ assessment.
  2. PABAK values for individual tests ranged from 0.36 to 0.84, indicating fair to substantial reliability.
  3. The study included 25 patients aged 20-65 with LBP, evaluating 2100 measurements across tests.
  4. Inter-examiner reliability for clusters reached PABAK values from 0.44 to 0.92, indicating moderate to excellent reliability.
  5. Kappa values must consider prevalence and bias, making PABAK a preferable metric for reliability interpretation.

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