Semester

Spring

Date of Graduation

2009

Document Type

Thesis

Degree Type

MS

College

College of Physical Activity and Sport Sciences

Department

Athletic Training

Committee Chair

Michelle A. Sandrey.

Abstract

Context. The sacroiliac joint is the largest axial joint in the body. Based on the function of transferring loads and providing stability, there is an increase risk of dysfunction. Sacroiliac joint tests exist to assess mobility and pain; however, there are few reliable tests for sacroiliac joint dysfunction and virtually no study which examined the reliability of experienced and inexperienced athletic trainers. Objective. The purpose of this study is to determine inter- and intrarater reliability for a battery of sacroiliac joint tests for experienced and inexperienced examiners. Design. This study was a single blind prospective reliability study. Setting. This study took place at HealthWorks Rehab and Fitness in Morgantown, WV. Patients and other participants. A total of four examiners were used for this study. Two examiners were inexperienced graduate certified athletic trainers while the other two examiners had five or more years of experience. A total of four recorders recorded data for each examiner. A total of 31 healthy male and female subjects age 20.7 +/- 2.4 years old without a previous history of back surgery or lower limb surgery within the last two years volunteered for this study. Interventions. After a practice session, two experienced and two inexperienced examiners performed a battery of sacroiliac joint tests on the subjects. The tests performed were the standing flexion test, standing stork/Gillet test, seated flexion test, and supine-to-sit test. The examiners performed each test three times and then reported to a recorder if the test was positive or negative. This procedure was completed in two rounds, the original day and again after the first round was completed. Main outcome measures. The expectations of this study was to determine if the experienced examiners had moderate to high interrater and intrarater reliability for sacroiliac joint tests as compared to inexperienced examiners who were anticipated as having low to moderate intrarater and interrater reliability for sacroiliac joint tests. Results. Intrarater reliability of the March test ranged from .351 to .53. Interrater reliability of the March test for all examiners ranged from -.090 to .335. Intrarater reliability of the Standing Flexion test ranged from .410 to .686. Interrater reliability of the Standing Flexion test for all examiners ranged from -.220 to .384. The interrater reliabilityof the Seated Flexion test ranged from .517 to .708. Interrater reliability of the Seated Flexion test for all examiners ranged from -.069 to .184. Intrarater reliability of the Supine to Long Sit test for each examiner ranged from .241 to .735. Interrater reliability of the Supine to Long Sit test for all examiners ranged from -.091 to .479. Percent agreement for all four tests ranged from 35% to 100%. Overall, intrarater reliability was higher than interrater reliability; however, there was no clear distinction between experienced and inexperienced examiners as defined by the study. Conclusion. This study found that intrarater reliability is higher than interrater reliability for four sacroiliac joint tests. Interrater reliability was extremely variable amongst the four examiners. It is important to note that it is not experience in years, but rather amount of daily exposure to sacroiliac joint testing that equates to increased reliability. These results support the need for a standardized teaching protocol for SIJ tests to increase interrater reliability. Because of the high intrarater reliability and low interrater reliability, one can also deduce that, from a clinical standpoint, the same individual should evaluate and treat the same patient daily.

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