Can back pain caused by symptom-giving sacroiliac joint relaxation ...

3.4.2. Pain provocation SIJ test
Provocation SIJ test series according to Laslett
In 1994, Pescioli et al. first reported study results on a good to excellent agreement
of seven provocation SIJ tests according to Laslett [30]. [48] The authors state that at
least four of these tests have to be positive in order to be able to speak of an SIJ
dysfunction.
The pain provocation tests of distraction, compression, thigh thrust, and pelvic torsion
(see table 3A) have substantial intertherapist reliability (see table 3C). The sacral
thrust and cranial shear procedures (see table 3A) are moderately reliable (see table
3C). [30]
Sacroiliac test Picture I.A.
(n=51) [30]
K
(n=51) [30]
Sensitivity
(n=48) [31]
Specificity
(n=48) [31]
Distraction Fig. 3F 88.2 0.69 0.60 0.81
Compression Fig. 3G 88.2 0.73 0.69 0.69
Sacral thrust Fig. 3H 78.0 0.52 0.63 0.75
Thigh thrust Fig. 3I 94.1 0.88 0.88 0.69
Pelvic torsion right Fig. 3J 88.2 0.75 0.53 0.71
Pelvic torsion left Fig. 3K 88.2 0.72 0.50 0.75
Cranial shear Fig. 3L 84.3 0.61 X X
I.A. = interexaminar agreement; K = kappa agreement coefficient
Table 3A: Specific values of the tests according to Laslett
In 2005 Laslett published a study [31] on the sensitivity and specificity of the
provocation SIJ test in which he examined only six pain provocation SIJ tests.
Unfortunately in this publication he did not refer to the 1994 study; hence it is not
clear why he examined one test less in the latter study.
The thigh thrust test is the most sensitive test and the distraction test is the most
specific one. In order to increase the sensitivity and the specificity, all six tests are
assessed together.
Master’s Thesis Wolfgang Aspalter 41