Differences in Physical Examination Outcomes between Sacroiliac Joint Motion Restricted and Painful Groups in Patients with Lumbopelvic Pain

Abstract

Background Among sacroiliac joint (SIJ) special tests, motion palpation tests (MPT) are commonly used to assess possible SIJ motion dysfunction. Pain provocation tests (PPT) attempt to assess whether or not the stressed structure is a source of pain. Pain and dysfunction are dissimilar concepts and should be differentiated from each other in clinical practice. Objectives The purpose of this study was to compare differences in physical examination outcomes (hamstring muscle length, isometric gluteus maximus strength, pelvic rotation angle during active straight leg raise (ASLR) and visual analog scale (VAS) between motion-restricted and painful groups of patients with low back pain (LBP). Methods Thirty-two patients between the ages of 18 and 45 participated. Four MPT (Gillet, standing flexion, sitting flexion, and supine to sit) and five PPTs (compression, distraction, Gaenslen's, thigh-thrust, and sacral-thrust) were used for distinguishing subjects with SIJ dysfunction. Independent t-test analysis was used to compare physical examination outcomes between the two groups. Results Results showed that SIJ PPT groups were significant changes (p = 0.028) in hamstring length compared to the SIJ MPT groups, and the subjective pain level (VAS) also showed a significant result. (p < 0.001) In the measurement of the pelvic rotation angle during the ASLR, the MPT group showed a more significant change in pelvic rotation angle than the PPT group (p = 0.043) However, our data did not show a significant difference in the isometric gluteus maximus strength of the two groups. (p = 0.882) Conclusions Based on these results, therapeutic interventions for SIJ dysfunction should be appropriately and harmonized by identifying the differences and unique features of the two test methods, and new evaluation methods combining these two methods are required.