Inter-examiner reliability of four static palpation tests used for assessing pelvic dysfunction
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Updated: Jul 17, 2026

Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse (POP) Quantification System
Published on: September 20, 2018
Ulrika Holmgren1, Kerstin Waling
1Department of Community Medicine and Rehabilitation, Physiotherapy Umeå University, Umeå, Sweden. ulrika.holmgren@vll.se
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.
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