AN EXPLORATORY STUDY ON THE FEASIBILITY OF A SIDE-POSTURE VERSION OF THE GILLET TEST
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Keywords
Palpation; Ilium; Anatomic Landmarks; Motion; Physical Examination; Sacroiliac Joint
Abstract
Objective: Previous research showed the Gillet sacroiliac joint (SIJ) motion test could not distinguish between actual SIJ movement and Trendelenburg-like pelvic obliquity. This study determined the feasibility of gathering data using a side-posture version of the Gillet test. The secondary goal was to determine if the results depended on whether the hip on the tested side was flexed actively or passively.
Methods: Subjects were placed in a baseline side-posture with the hip and knee of the lower leg flexed 450, with the upper leg straight. An examiner positioned his thumbs on the upside posterior superior iliac spine (PSIS) and S2 tubercle. The subject actively flexed the upper leg hip so it was superimposed over the lower leg, the examiner’s thumbs in place. After returning to the baseline position, a research assistant created passive flexion of the hip. Photographs were taken for the baseline, active hip flexion, and passive hip flexion positions. Photometric analysis measured PSIS/S2 displacements for all 3 test positions, left and right.
Results: A convenience sample of 34 asymptomatic subjects (68 SIJs) was recruited, 64.7% male. During active hip flexion the PSIS rose 2.22mm cephalad relative to S2; during passive hip flexion, it dropped 1.88mm. 29% of SIJs exhibited no movement. Wilcoxon testing confirmed statistical significance. Mean SIJ movement: 3.20mm caudal during passive hip flexion.
Conclusion: Although, it is feasible to perform Gillet testing in side posture, it is easier to perform with an assistant creating passive hip flexion.
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References
2. van der Wurff P, Meyne W, Hagmeijer RH. Clinical tests of the sacroiliac joint. Man Ther 2000;5(2):89-96. Epub 2000/07/21. doi: 10.1054/math.1999.0229 S1356689X99902291 [pii]. PubMed PMID: 10903584
3. Arab AM, Abdollahi I, Joghataei MT, Golafshani Z, Kazemnejad A. Inter- and intra-examiner reliability of single and composites of selected motion palpation and pain provocation tests for sacroiliac joint. Man Ther 2009;14(2):213-221. Epub 2008/04/01. doi: S1356-689X(08)00035-0 [pii] 10.1016/j.math.2008.02.004. PubMed PMID: 18373938
4. Soleimanifar MK, N, Arab AM. Association between composites of selected motion palpation and pain provocation tests for sacroiliac joint disorders. J Bodywork Movement Ther 2017;21:240-245
5. Potter L, McCarthy C, Oldham J. Intraexaminer reliability of identifying a dysfunctional segment in the thoracic and lumbar spine. J Manipulative Physiol Ther 2006;29(3):203-207. doi: 10.1016/j.jmpt.2006.01.005. PubMed PMID: 16584944
6. Haneline M, Cooperstein R, Young M, Birkeland K. An annotated bibliography of spinal motion palpation reliability studies. J Can Chiropr Assoc 2009;53(1):40-58. PubMed PMID: 19421352
7. Lee D. The One-leg Standing test and the active straight leg raise test: a clinical interpretation of two tests of load transfer through the pelvic girdle. Orthop Division Rev [Internet]. 2005 Feb. 13, 2018. Available from: http://dianelee.ca/articles/LoadTransfertests.pdf
8. Hungerford B, Gilleard W, Lee D. Altered patterns of pelvic bone motion determined in subjects with posterior pelvic pain using skin markers. Clin Biomech. 2004;19(5):456-464. PubMed PMID: 15182980
9. Mootz RD, Hansen DT, editors. Chiropractic technologies. Gaithersburg, MD: Aspen Publishers, Inc.; 1990
10. Curnow D, Cobbin D, Wyndham J. Reliability of the Stork Test: Is starting stance important? Chiropr J Australia 2010;40(4):137. PubMed PMID: 0140485
11. Hungerford BA, Gilleard W, Moran M, Emmerson C. Evaluation of the ability of physical therapists to palpate intrapelvic motion with the Stork test on the support side. Phys Ther 2007;87(7):879-887. PubMed PMID: 17472953
12. Kapandji A. The physiology of the joints. vol 3. New York, NY; Churchill Livingstone; 1974:251
13. Meijne W, van Neerbos K, Aufdemkampe G, van der Wurff P. Intraexaminer and interexaminer reliability of the Gillet test. J Manipulative Physiol Ther 1999;22(1):4-9. PubMed PMID: 10029942
14. Plaugher G, editor. Textbook of clinical chiropractic: a specific biomechanical approach. Baltimore, Maryland: Williams & Wilkins; 1993
15. Cooperstein R, Young M, Haneline M. At what angle of hip flexion is the Gillet test the most effective for detecting sacroiliac motion? J Chiropr Educ 2011;25(1):76-77
16. Cooperstein RT, Felisha. Does the Gillet Test assess sacroiliac motion, or does it more likely reflect asymmetric one-legged stance patterns? J Canadian Chiropr Assoc 2018;62(2):85-97
17. Bowen DJ, Kreuter M, Spring B, et al. How we design feasibility studies. Am J Prev Med 2009;36(5):452-457. doi: 10.1016/j.amepre.2009.02.002. PubMed PMID: 19362699; PubMed Central PMCID: PMCPMC2859314
18. Kendall FP, McCreary EK, Provance PG, Rodgers MM, Romani WA. Muscles testing and function with posture and pain. 5 ed. Baltimore, MD: Williams & Wilkins; 2005:480
19. Goode A, Hegedus EJ, Sizer P, Brismee JM, Linberg A, Cook CE. Three-dimensional movements of the sacroiliac joint: a systematic review of the literature and assessment of clinical utility. J Man Manip Ther 2008;16(1):25-38. PubMed PMID: 19119382
20. Harrison DE, Harrison DD, Troyanovich SJ. The sacroiliac joint: a review of anatomy and biomechanics with clinical implications. J Manipulative Physiol Ther 1997;20(9):607-617
21. Sturesson B, Uden A, Vleeming A. A radiostereometric analysis of movements of the sacroiliac joints during the standing hip flexion test. Spine.
2000;25(3):364-368. PubMed PMID: 10703111
22. Gupta S, Arora K. Study of significance of total pelvic height and pelvic width in sex determination of human innominate bone in Gujarat region GCSMC J Med Sci 2013;3(3):38-41
23. Pitkin H, Pheasant H. Sacrarthrogenetic telalgia. II A study of sacral mobility. JBJS 1936;18(2):365-375
24. Smidt GL, Wei SH, McQuade K, Barakatt E, Sun T, Stanford W. Sacroiliac motion for extreme hip positions. A fresh cadaver study. Spine 1997;22(18):2073-2082
25. Vleeming A, Schuenke MD, Masi AT, Carreiro JE, Danneels L, Willard FH. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat 2012;221(6):537-567. doi: 10.1111/j.1469-7580.2012.01564.x. PubMed PMID: 22994881; PubMed Central PMCID: PMCPMC3512279
26. Snijders CJ, Vleeming A, Stoeckart R. Transfer of lumbosacral load to iliac bones and legs Part 1: Biomechanics of self-bracing of the sacroiliac joints and its significance for treatment and exercise. ClinBiomechanics 1993;8(6):285-294. Epub 1993/11/01. doi: 0268-0033(93)90002-Y [pii] 10.1016/0268-0033(93)90002-Y. PubMed PMID: 23916048