Validity and Reliability of Palpatory Clinical Tests of Sacroiliac Joint Mobility: A Systematic Review and Meta-analysis.

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.
(Copyright © 2021. Published by Elsevier Inc.)