A Radiostereometric Analysis of Movements of the Sacroiliac Joints During the Standing Hip Flexion Test

Sturesson, Bengt; Udén, Alf; Vleeming, Andry

doi:10.1097/00007632-200002010-00018

Cited by 132 publications

(99 citation statements)

References 22 publications

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“…10 In a review of SIJ anatomy and biomechanics, motion occurring at the SIJ was reported to be a combination of rotation and translation that did not occur around a simple axis. 11 The motions available at the SIJ have been repeatedly found to be small, 12,13 not exceeding 2-3° or 1-2mm. 11 The SIJ has been implicated as a common source of LBP.…”

Section: Introductionmentioning

confidence: 98%

Methods used by members of the Australian osteopathic profession to assess the sacroiliac joint

Peace

Fryer

2004

Journal of Osteopathic Medicine

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The range and frequency of clinical tests used by Australian osteopaths to detect sacroiliac joint dysfunction (SIJD) is unknown. The aim of this study was to determine what clinical tests are employed by Australian osteopaths to assess for SIJD, and determine whether a correlation existed between these tests and clinical experience. Surveys were mailed to all Australian osteopathic practice locations listed in the current phone directory. 168 osteopaths responded to the survey, with an estimated response rate of 30%. Most respondents reported they utilise asymmetry of bony landmarks, motion tests and pain provocation tests to detect SIJD. The PSIS (94%) was most frequently examined for asymmetry, sacral springing (prone) (73%) was the most frequently reported motion test, and the piriformis (80%) was most frequently examined for tenderness and/or tissue texture change. Only 14% of respondents completely abstained from using pain provocation testing. It appeared that many osteopaths used diagnostic procedures consistent with the model proposed by Mitchell, but supported them with other motion and pain provocation tests. The use of standard tests commonly advocated in the osteopathic literature declined with increasing practitioner experience, whereas the use of a wide range of idiosyncratic 1 tests increased. It appeared that the majority of osteopaths use pain provocation tests, which are not advocated by any osteopathic text, but commonly referred to in the wider manual therapy literature.

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Section: Introductionmentioning

confidence: 98%

Methods used by members of the Australian osteopathic profession to assess the sacroiliac joint

Peace

Fryer

2004

Journal of Osteopathic Medicine

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“…Different radiographic modalities have been used to measure movement in the sacroiliac (SI) joint objectively [7,12,15], whereas five studies have used RSA to evaluate movement between the sacrum and the ilium [16][17][18][19][20]. With RSA, a maximum rotation of 3.6°has been measured and the translation never exceeded 2 mm in the SI joint, which is less movement than other methods have revealed [5], and for this reason the method has been questioned [3].…”

Section: Introductionmentioning

confidence: 99%

“…Earlier studies have measured movement between the sacrum and the ilium with dorsally placed markers [16][17][18][19][20]. In these studies, the markers were placed close to the joint line, and because of the flat anatomy of the bones, the markers become collinear (in the same plane).…”

Section: Introductionmentioning

confidence: 99%

Precision and Accuracy Measurement of Radiostereometric Analysis Applied to Movement of the Sacroiliac Joint

Kibsgård

Røise

Stuge

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Different techniques have been used to quantify the movement of sacroiliac (SI) joints. These include radiostereometric analysis (RSA), but the accuracy and precision of this method have not been properly evaluated and it is unclear how many markers are required and where they should be placed to achieve proper accuracy and precision. Purpose The purpose of this study was to test accuracy and precision of RSA, applied to the SI joint, in a phantom model and in patients. Methods We used a plastic phantom attached to a micrometer to obtain a true value of the movement of the SI joint and compared this value with the measured value obtained by RSA; the difference represented the accuracy. The precision of the system was measured by double examination in the phantom and in six patients, and was expressed by a limit of significance (LOS). We analyzed different marker distributions to find optimal marker placement and number of markers needed. Results The accuracy was high and we identified no systematic errors. The precision of the phantom was high with a LOS less than 0.25°and 0.16 mm for all directions, and in patients, the precision was less than 0.71°for rotations and 0.47 mm translations. No markers were needed in the pubic symphysis to obtain good precision. Conclusions The accuracy and precision are high when RSA is used to measure movement in the SI joint and support the use of RSA in research of SI joint motion.

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“…These are very large numbers relative to some very conservative contemporary estimates of sacroiliac mobility, such as those of Sturesson et al [31][32][33] and those appearing in a review article by Goode et al 34 However, the 1.5 in of artificial LLI created by Pitkin and Pheasant is also very large compared with the amount of LLI produced or found in other studies herein reviewed, some of which showed a linear, monotonic dose response of pelvic torsion to induced LLI. Moreover, the mean amount of torsion reported by them is within shouting distance of other modern investigators who have reported far more torsion to occur, such as a clinical study by Cibulka et al, 35 a cadaveric study using advanced imaging by Smidt et al, 36 another clinical study by Smidt et al, 37 and the Drerup and Hierholzer 20 study included in this review.…”

Section: Study Observationsmentioning

confidence: 86%

The relationship between pelvic torsion and anatomical leg length inequality: a review of the literature

Cooperstein

Lew

2009

Journal of Chiropractic Medicine

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Objective: Although it is common to find assertions relating functional leg length inequality (LLI) to pelvic torsion and other states of subluxation, comments and/or data concerning anatomical LLI in this same context are uncommon. This review of the literature synthesizes the evidence on pelvic torsion in relation to anatomical LLI. Methods: The literature was searched using the PubMed; Manual, Alternative, and Natural Therapy Index System; Allied and Complementary Medicine Database; Cumulative Index to Nursing and Allied Health Literature; and Index to Chiropractic Literature databases for primary studies that related LLI, either artificially created or naturally occurring, to pelvic torsion. Extracted data included natural vs artificial LLI, method of creating or detecting LLI, subject selection, methodology for measuring pelvic torsion, and results. Results: Nine English-language studies were retrieved published 1936-2004. Seven determined the impact of artificial, transient LLI on pelvic torsion, whereas 2 studied the effect of naturally occurring LLI. Conclusion: Across varying methodologies for measuring LLI and pelvic torsion, a consistent, dose-related pattern was identified in which the innominate rotates anteriorly on the side of a shorter leg and posteriorly on the side of the longer leg. This finding was contrary to the common assertion that the ilium rotates posteriorly on the side of a short leg and vice versa. Practitioners of manual medicine who derive vectors for intervention based on leg checking procedures should consider the possibility that the direction of pelvic torsion may be variable depending on whether the LLI is of anatomical or functional origin.

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A Radiostereometric Analysis of Movements of the Sacroiliac Joints During the Standing Hip Flexion Test

Cited by 132 publications

References 22 publications

Methods used by members of the Australian osteopathic profession to assess the sacroiliac joint

Methods used by members of the Australian osteopathic profession to assess the sacroiliac joint

Precision and Accuracy Measurement of Radiostereometric Analysis Applied to Movement of the Sacroiliac Joint

The relationship between pelvic torsion and anatomical leg length inequality: a review of the literature

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