Reliability and validity of a new clinical test for assessment of the sacroiliac joint dysfunction.
Apurv Shimpi, Renuka Hatekar, Ashok Shyam and 1 others
PMID 30930575WHAT IT FOUND
A new prone test for suspected sacroiliac joint pain gave consistent results between clinicians and compared well with other bedside tests.
But the study had no true diagnostic standard, so it cannot yet be trusted to diagnose SIJ dysfunction.
Key findings
01The Shimpi Prone SIJ test was consistent when repeated by the same assessor and when assessed by another assessor, with reliability values above 0.8 and agreement values above 0.6.
02The Shimpi Prone SIJ test had 79.9% validity, 82% sensitivity and 77% specificity compared with the two reference tests.
03A positive Shimpi Prone SIJ test required familiar pain plus lifting of the ASIS off the examiner's palm during active hip extension.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
There was no invasive fluoroscopic pain-block gold standard, so the new test was judged against two other clinical tests rather than a true diagnostic standard. The analysed sample was small and mixed: 23 adults with low back pain and 22 healthy volunteers, from one centre in India. The healthy group was selected only by absence of back pain or dysfunction and no back pain in the last three years. The test requires prone lying and active hip extension, so it may be unusable in pregnancy, severe obesity, or weakness of the back or hip muscles. The test relies on hip motion, so hip joint disease such as avascular necrosis or osteoarthritis could make it misleading.
Declared interests
All contributing authors declared no conflicts of interest.
The easy way to misread this
Do not read the reported validity as proof that the test diagnoses SIJ dysfunction. The study had no fluoroscopically guided pain-block gold standard and used other clinical tests as reference.