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Loudovici-Krug D, Lemhöfer C, Best N. Standing Flexion Test: A Manual Diagnostic Test as First Indication
of Sacroiliac Dysfunction – Study from Practice. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2022. [DOI: 10.1055/a-1967-2509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract
Background The standing flexion test (SFT) is an orienting test,
supporting to diagnose a sacroiliac joint dysfunction (SIJ-D) in manual
medicine. However, the literature research for this term shows the paucity of
according investigations. The aim is to investigate the importance of the SFT
with regard to possible functional disorder of the SIJ.
Method Teachers of the Medical Association for Manual Medicine
(physiotherapists and physicians) were asked to fill in a documentation sheet
considering different exsmination procedures belonging to routine manual
medicine anamnestic findings. The only inclusion criterion was the positive SFT.
The results are presented descriptive with according percentages.
Results From January to August 2019, a total of 366 SIJ data sheets with
positive SFTs were completed by 20 ÄMM-teachers, involving six
imcomplete ones. 263 of the 360 patients enrolled actually had a SIJ-D
(73.06%).Further relevant results refer to pain oft he SIJ region (205 of 360; 173 with
SIJ-D), the Patrick-Kubis-Test (246 of 360; 201 with SIJ-D), the pelvic tilt
(134 of 360; 134 with SIJ-D), the pelvic torsion (209 of 360; 164 with SIJ-D)
and the increased iliac muscle tone (282 of 360; 216 with SIJ-D).
Discussion After a positive SFT, the Patrick-Kubis-test, the tonus check
of the iliac muscle and the indication of pain in the SIJ-region can be used for
the diagnosis of a SIJ-D. If at least two of the three aspects are conspicuous,
SIJ-D is very likely to be present.
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Affiliation(s)
- Dana Loudovici-Krug
- Institute for Physiotherapy, Jena University Hospital,
Jena
- Research Consulting office of the ÄMM (Medical Association
Manual Medicine)
| | | | - Norman Best
- Institute for Physiotherapy, Jena University Hospital,
Jena
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Conde-Vázquez O, Mohíno-Fernández C. Intra- and inter-observer concordance of a fascial standing flexion test in children. J Bodyw Mov Ther 2022; 30:95-99. [DOI: 10.1016/j.jbmt.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/08/2021] [Accepted: 02/04/2022] [Indexed: 11/25/2022]
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Arumugam A, Mehta P, Shousha TM, Chandrasekaran B. Letter to the editor concerning a systematic review on clinimetric properties of sacroiliac joint mobility tests by Klerx et al. (2019). Musculoskelet Sci Pract 2021; 56:102177. [PMID: 34839928 DOI: 10.1016/j.msksp.2020.102177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/27/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates; Adjunct Faculty, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; Adjunct Faculty, Department of Physiotherapy, Universitas Binawan, Indonesia.
| | - Poonam Mehta
- Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, Sydney, NSW, Australia
| | - Tamer Mohamed Shousha
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates; Faculty of Physical Therapy, Cairo University, Egypt
| | - Baskaran Chandrasekaran
- Department of Exercise & Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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Klerx SP, Pool JJM, Coppieters MW, Mollema EJ, Pool-Goudzwaard AL. Response to the letter-to-the-editor by Arumugam et al. (2020). Musculoskelet Sci Pract 2021; 56:102198. [PMID: 34649832 DOI: 10.1016/j.msksp.2020.102198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 10/24/2022]
Affiliation(s)
- S P Klerx
- HU University of Applied Sciences Utrecht, Institute of Movement Sciences, Utrecht, the Netherlands
| | - J J M Pool
- HU University of Applied Sciences Utrecht, Institute of Movement Sciences, Utrecht, the Netherlands
| | - M W Coppieters
- Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Australia; Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - E J Mollema
- HU University of Applied Sciences Utrecht, Institute of Movement Sciences, Utrecht, the Netherlands
| | - A L Pool-Goudzwaard
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; SOMT University of Physiotherapy, Amersfoort, the Netherlands.
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Nolet PS, Yu H, Côté P, Meyer AL, Kristman VL, Sutton D, Murnaghan K, Lemeunier N. Reliability and validity of manual palpation for the assessment of patients with low back pain: a systematic and critical review. Chiropr Man Therap 2021; 29:33. [PMID: 34446040 PMCID: PMC8390263 DOI: 10.1186/s12998-021-00384-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 06/22/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Static or motion manual palpation of the low back is commonly used to assess pain location and reproduction in low back pain (LBP) patients. The purpose of this study is to review the reliability and validity of manual palpation used for the assessment of LBP in adults. METHOD We systematically searched five databases from 2000 to 2019. We critically appraised internal validity of studies using QAREL and QUADAS-2 instruments. We stratified results using best-evidence synthesis. Validity studies were classified according to Sackett and Haynes. RESULTS We identified 2023 eligible articles, of which 14 were low risk of bias. Evidence suggests that reliability of soft tissue structures palpation is inconsistent, and reliability of bony structures and joint mobility palpation is poor. We found preliminary evidence that gluteal muscle palpation for tenderness may be valid in differentiating LBP patients with and without radiculopathy. CONCLUSION Reliability of manual palpation tests in the assessment of LBP patients varies greatly. This is problematic because these tests are commonly used by manual therapists and clinicians. Little is known about the validity of these tests; therefore, their clinical utility is uncertain. High quality validity studies are needed to inform the clinical use of manual palpation tests.
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Affiliation(s)
- Paul S. Nolet
- Department of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, Ontario Canada
- School of Kinesiology, Lakehead University, Thunder Bay, Ontario Canada
- CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine, and Life Sciences, Maastricht University, 6211 LM Maastricht, The Netherlands
| | - Hainan Yu
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario Canada
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Ontario Canada
- Canadian Memorial Chiropractic College, Toronto, Ontario Canada
| | - Pierre Côté
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario Canada
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Ontario Canada
| | | | - Vicki L. Kristman
- EPID@Work Research Institute, Department of Health Sciences, and the Division of Human Sciences, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Ontario Canada
- Institute for Work and Health, Toronto, Ontario Canada
| | - Deborah Sutton
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario Canada
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Ontario Canada
| | - Kent Murnaghan
- Canadian Memorial Chiropractic College, Toronto, Ontario Canada
| | - Nadège Lemeunier
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Ontario Canada
- UMR1295, Université de Toulouse, UPS, Inserm, Toulouse, France
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Jones BM, Yoshida Y. Examination of the innominate movements in individuals with and without a positive march test. J Phys Ther Sci 2021; 33:596-600. [PMID: 34393370 PMCID: PMC8332646 DOI: 10.1589/jpts.33.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/13/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The March Test (MT), evaluating hypomobility of the sacroiliac joint (SIJ), is often used in clinical practice to evaluate low back pain but has limited reported validity and reliability. Capturing the innominate movement at SIJ associated with the results of MT has not been examined. The purpose of this study was to determine if there was a significant difference in the motion of the innominate between a positive and a negative MT. [Participants and Methods] Sixteen healthy volunteers were assigned into two groups: positive or negative results of the MT. All participants were asked to perform three different tasks: standing on both limbs, static standing on one-limb and flexing the hip to 90 and 100 degrees, and active flexing the hip past 90 degrees. In a 3D motion analysis system, virtual vectors created by landmarks over the ilium defined innominate movement of the ilium related to the sacrum, which were compared between the groups. [Results] There was significantly limited innominate movement in the March Test positive group compared to the March Test negative group. [Conclusion] This study showed hypomobility at SIJ in the March test positive groups. Further investigation is needed for clinical applications.
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Affiliation(s)
- Beth Moody Jones
- Division of Physical Therapy, University of New Mexico:
Albuquerque, NM 87131-1466, USA
| | - Yuri Yoshida
- Division of Physical Therapy, University of New Mexico:
Albuquerque, NM 87131-1466, USA
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Ribeiro RP, Guerrero FG, Camargo EN, Beraldo LM, Candotti CT. Validity and Reliability of Palpatory Clinical Tests of Sacroiliac Joint Mobility: A Systematic Review and Meta-analysis. J Manipulative Physiol Ther 2021; 44:307-318. [PMID: 33896601 DOI: 10.1016/j.jmpt.2021.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 07/18/2020] [Accepted: 01/20/2021] [Indexed: 01/16/2023]
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.
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Affiliation(s)
- Rafael P Ribeiro
- School of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
| | - Filipe G Guerrero
- School of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Eduardo N Camargo
- School of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Lucas M Beraldo
- Institute of Mathematics and Statistics (IME), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Cláudia T Candotti
- School of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Líška D, Zelník R, Hegedüšová N. Clinical examination of the sacroiliac joint. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2021. [DOI: 10.1177/22104917211000755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Sacroiliac joint (SIJ) can be a nociceptive source of the pain in lower back. Clinical diagnosis of SIJ pain remains yet problematic. The cause of SIJ pain is multifactorial. The pain may be a result of an inflammatory disease, arthrosis, traumatic injury, infectious process or overload. The potential role in SIJ examination have pain provocation tests. Objective: To review and further discuss the validity of some of the mostly used clinical provocation tests such as Distraction test, Thigh Thrust test, Compression test, Sacral Thrust test, Patrick’s (FABER), Gaenslen’s test, Standing Flexion Test, Gillet Test and Shimpi Prone test. Method: A literature search was conducted using PubMed. Reviewed were studies between 2005 and 2020 in English, Slovak and Czech with keywords: sacroiliac joint, sacroiliac assessment, provocation tests. The methodology of studies was not considered. Discussion: It is challenging to determine whether SIJ is the actual source of the pain by using only one of the provocation tests. Therefore, it is beneficial to combine more compression tests, what will also increase the validity of testing. Other widely used SIJ tests are palpation test, however their validity is poor.
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Affiliation(s)
- D Líška
- Matej Bel University, Faculty of Arts, Department of Physical Education and Sports, Banska Bystrica, Slovakia
| | - R Zelník
- Orthopedics clinic, Slovak Medical University, F. D. Roosevelt University Hospital in Banská Bystrica, Slovakia
- Department of Rehabilitation, Slovak Medical University, F. D. Roosevelt University Hospital in Banská Bystrica
| | - N Hegedüšová
- Matej Bel University, Faculty of Arts, Department of Physical Education and Sports, Banska Bystrica, Slovakia
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Coşkun R, Aksoy B, Alptekin K, Alptekin JÖ. Efficiency of high velocity low amplitude (HVLA) lumbosacral manipulation on running time and jumping distance. MANUELLE MEDIZIN 2020. [DOI: 10.1007/s00337-020-00663-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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