Standing Forward Flexion Test
Purpose: To assess for hypomobility of the sacroiliac joint.
Test Position: Standing.
Performing the Test: The examiner places one hand on the test side's PSIS and the other hand on S2 spinous process. The patient then bends forward. The test is repeated on the opposite side. A positive test occurs when one PSIS is noted to move in the superior direction more than the other. This test can also be performed while palpating both PSIS's simultaneously.
Diagnostic Accuracy: Sensitivity: .17; Specificity: .79 ( "Four clinical tests of sacroiliac joint dysfunction: the association of test results with innominate torsion among patients with and without back pain").
Importance of Test: It is a debatable topic as to whether there is motion occurring at the SI joint. This test is used to determine if restrictions are present in the sacroiliac joint. As the patient bends forward, the structures that attach to the pelvis rotate the inominates in an anterior direction relative to the starting position. This is why the PSIS's are felt moving superiorly. Should there be a restriction in one of the sacroiliac joints, the PSIS will not feel like it's moving as high as the opposite side. It should be noted that abnormal SI motion can be found in asymptomatic patients, so this test should not be used to triangulate the origin of the patient's symptoms.
Note: tests should only be performed by a properly trained health care practitioner.
Test Position: Standing.
Performing the Test: The examiner places one hand on the test side's PSIS and the other hand on S2 spinous process. The patient then bends forward. The test is repeated on the opposite side. A positive test occurs when one PSIS is noted to move in the superior direction more than the other. This test can also be performed while palpating both PSIS's simultaneously.
Diagnostic Accuracy: Sensitivity: .17; Specificity: .79 ( "Four clinical tests of sacroiliac joint dysfunction: the association of test results with innominate torsion among patients with and without back pain").
Importance of Test: It is a debatable topic as to whether there is motion occurring at the SI joint. This test is used to determine if restrictions are present in the sacroiliac joint. As the patient bends forward, the structures that attach to the pelvis rotate the inominates in an anterior direction relative to the starting position. This is why the PSIS's are felt moving superiorly. Should there be a restriction in one of the sacroiliac joints, the PSIS will not feel like it's moving as high as the opposite side. It should be noted that abnormal SI motion can be found in asymptomatic patients, so this test should not be used to triangulate the origin of the patient's symptoms.
Note: tests should only be performed by a properly trained health care practitioner.
References:
Levangie PK. "Four clinical tests of sacroiliac joint dysfunction: the association of test results with innominate torsion among patients with and without back pain." Phys Ther. 1999 Nov;79(11):1043-57. Web. 08/19/2012.
Levangie PK. "Four clinical tests of sacroiliac joint dysfunction: the association of test results with innominate torsion among patients with and without back pain." Phys Ther. 1999 Nov;79(11):1043-57. Web. 08/19/2012.
