On “Ilial anterior rotation…” Vaughn HT, Nitsch W. Phys Ther. 2008;88:1578–1590.

Abstract

I was surprised by the content of the article by Vaughn and Nitsch1 and the inductive and often contradictory logic used throughout the case report. The current evidence-based literature on low back pain is leaning heavily toward a treatment-based classification system, with an active treatment paradigm.2,3 This article seems to fly in the face of this evidence and proposes a structural-based diagnostic classification based on poor tests and passive treatment, namely bed rest, transcutaneous electrical nerve stimulation, ice, ultrasound, massage, and taping.4–8 The active treatment provided to the patient appears to be based on inductive reasoning to address the pseudo-diagnostic category arrived at by a series of nonvalid tests, proposed by the authors, and poorly supported by the evidence and anecdotal reference to opinion-based papers. In the introduction, the authors do review the current evidence-based literature and outline that most testing procedures for the sacroiliac (SI) complex have poor validity, yet proceed to ignore this and use the nonvalid tests …