Intraexaminer and interexaminer reliability of the Gillet Test
The purpose of this study was to determine the intraexaminer and interexaminer reliability of the Gillet test.
In a test-retest study the incidence of asymmetric or symmetric sacroiliac joint motion was investigated with the Gillet test.
Forty-one male subjects volunteered for this study (mean age, 23 +/- 2.24 years). Thirty-eight subjects were examined in the first test procedure, and at least 4 days later 37 subjects were examined again. The subjects were subdivided into symptomatic and asymptomatic groups on the basis of certain criteria.
To obtain the intraexaminer and interexaminer reliability values, Cohen's kappa, the percentage agreement, bias-adjusted kappa, and prevalence-adjusted bias-adjusted kappa were used. The mean Cohen's kappa did not exceed the value of 0.081. Only the percentage agreement of the symptomatic group did exceed the minimum level of 80%. When kappa was positive, the prevalence-adjusted bias-adjusted kappa was markedly higher than kappa; when kappa was negative, the prevalence-adjusted bias-adjusted kappa was only slightly higher than kappa. Only small differences were found between kappa and bias-adjusted kappa.
The Gillet test, as performed in this study, does not appear to be reliable.
Available from: PubMed Central
- "Testing palpation accuracy is challenging because different clinicians vary in their treatment paradigm and professional experience, even though there is standardized medical school training. Moir et al  notes that each clinician develops his or her own criteria by which to determine standards of any given test procedure, and there can be a difference in interpretation of the findings  and difficulty with these findings being objectively measured . Therefore, it is not surprising that studies showing that palpatory accuracy is related to experience have been conflicting in their findings [2,4-6]. "
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ABSTRACT: To determine whether osteopathic medical students, fellows, residents, and practicing physicians differ in their ability to identify inanimate objects and if these skills relate to palpatory experience.
Fifteen commonly known objects were fixed to a board and blinded with a cotton cloth. In Part I of testing, participants were asked to identify 9 objects, with choices provided. In Part II participants were asked to identify 6 objects using one word only. Part III consisted of identifying the shape of an object in Part II.
Eighty-nine osteopathic medical students, fellows, residents, and practicing physicians participated in the study. Overall, correct identification of objects was higher in Part I with choices than in Part II without choices available. No statistically significant difference was found among osteopathic medical students, fellows, residents, and practicing physicians in the correct identification of the objects.
Accuracy in tactile identification of objects among varying levels of palpatory experience was not found. Correlation with clinical palpation cannot be made as it requires a subset of palpatory skills not tested in this study. Accuracy and measurement of palpation should be studied further to demonstrate if palpatory experience improves palpatory accuracy.
- "The patient was instructed to stand on one leg while flexing the contralateral hip and flexing his knee toward the chest. The test result was recorded as positive, when the PSIS failed to move posterior and inferior with respect to S2   . For each participant Sphinx test was performed in which the patient was in prone position with backward bending. "
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ABSTRACT: To determine the relative frequency of sacroiliac joint dysfunction in a sample of patients with image proven lumbar disc herniation.
A single group cross-sectional study was conducted in a three year period from 2007 in an outpatient clinic at a university hospital. Overall, 202 patients aged more than or equal to 18 years with image proven herniated lumbar disc and with physical findings suggestive of lumbosacral root irritation were included.
Overall, 146 (72.3%) participants had sacroiliac joint dysfunction. The dysfunction was significantly more prevalent in females (p< 0.001, adjusted OR=2.46, 95% CI=1.00 to 6.03), patients with recurrent pain (p< 0.005, adjusted OR=2.33 with 95% CI=1.10 to 4.89) and patients with positive straight leg raising provocative test (p< 0.0001, adjusted OR=5.07, 95% CI=2.37 to 10.85). There was no significant relationship between the prevalence of SIJD, and working hours, duration of low back pain, or body mass index.
Sacroiliac joint dysfunction is a significant pathogenic factor with high possibility of occurrence in low back pain. Thus, regardless of intervertebral disc pathology, sacroiliac joint dysfunction must be considered in clinical decision making.
Available from: Annelies Pool-Goudzwaard
- "Many tests and techniques are available for physical/manipulative therapists to assess and mobilize the joints of the pelvic ring (Sturesson et al., 2000a, 2000b; Laslett et al., 2003, 2005; van der Wurff et al., 2006; Hungerford et al., 2007; v). Often, during mobility tests the positions of the Posterior Superior Iliac Spines (PSIS) are palpated before, during and after movement of the spine and/or lifting a leg, and conclusions on sacroiliac joint (SIJ) mobility are drawn from changes in the position of one PSIS with respect to the other on the opposite side (Bowman and Gribble, 1995; Meijne et al., 1999; Vincent-Smith and Gibbons, 1999; Sturesson et al., 2000a, 2000b; Hungerford et al., 2007). The tests are based on the assumption that the innominates will not deform during these movements. "
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The transversus abdominis muscle is thought to exert a stiffening effect on the sacroiliac joints. However, it is unknown whether this muscle is capable of increasing pubic symphysis and innominate bone stiffness during load exerted on the pelvis. The objective of this study is to investigate whether in vitro simulated force of transversely oriented fibres of the transversus abdominis increases stiffness of the pubic symphysis and innominate bone.
In 15 embalmed specimens an incremental moment was applied in the sagittal plane to one innominate with respect to the fixated contralateral innominate. For pubic symphysis motion and innominate bone deformation load-deformation curves were plotted and slopes of adjusted linear regression lines were calculated. The slopes are considered to be a measure of pubic symphysis and innominate bone stiffness. Slopes were tested for significant differences before and after simulation of the transversus abdominis force.
Stiffness of pubic symphysis and innominate bone does not change under influence of simulated force of the transversus abdominis. For pubic symphysis, the slope of the regression line hardly changes, from 0.0341mm/Nm (SD 0.0277) before transversus abdominis force simulation to 0.0342mm/Nm (SD 0.0273) during simulation. For innominate bone, the mean slope increases minimally, from 0.0368mm/Nm (SD 0.0369) to 0.0413mm/Nm (SD 0.0395), respectively.
Simulation of the force of a single muscle - transversus abdominis - does not increase stiffness of the pubic symphysis and innominate bone. The hypothesized stiffening influence of the transversus abdominis on the pelvic ring was not confirmed in vitro.
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