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The reliability of selected pain provocation tests for sacroiliac joint pathology
1McKenzie Institute International, Wellington, New Zealand.
Objective:
To assess the inter-rater reliability of seven pain provocation tests for pain of sacroiliac origin in low back pain patients.
Summary Of Background Data:
Previous studies on the reliability of such tests have produced inconclusive and conflicting results.
Methods:
Fifty-one patients with low back pain, with or without radiation into the lower limb, were assessed by one examiner and another drawn from a pool of five. Percent agreement and the Kappa statistic were used to evaluate the reliability of the seven tests.
Results:
Percent agreement and the Kappa statistic ranged in value from 78% and 0.52 (P < 0.001) to 94% and 0.88 (P < 0.001), respectively, when results for all examiner pairs were pooled. However, two tests demonstrated only marginal reliability when performed by one pair of assessors that examined 43% of the patients.
Conclusions:
Five of seven tests employed in this study were reliable, the other two were potentially reliable. These tests may be used to detect a sacroiliac source of low back pain, although sensitivity and specificity studies are needed to determine their diagnostic power.