Nejati Parisa, Sartaj Elham, Imani Farnad, Moeineddin Reza, Nejati Lida, Safavi Marta
Department of Sports and Exercise Medicine, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Department of Anesthesiology and Pain Medicine, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
J Chiropr Med. 2020 Mar;19(1):28-37. doi: 10.1016/j.jcm.2019.12.002. Epub 2020 Sep 12.
The purpose of this study was to assess the reliability and validity of motion palpation and pain provocation compared with sacroiliac joint (SIJ) block as the gold-standard assessment method of patients with sacroiliac joint dysfunction (SIJD).
A cross-sectional study was conducted in the Department of Sports and Exercise Medicine at Rasool Akram Hospital. Forty-eight patients suspected of having SIJD were selected from a total of 150 patients on the basis of a combination of symptoms, physical tests, and magnetic resonance imaging findings. The patients suspected of having SIJD received the SIJ block, to which the accuracy of all the physical tests was compared. Sensitivity, specificity, and positive and negative predictive values were calculated for each test. The receiver operating characteristic curve and the area under the receiver operating characteristic curve were measured.
The Flexion, Abduction and External Rotation (FABER) test had the highest specificity and positive predictive values of the physical tests. Furthermore, the combination of the FABER test and the thigh thrust test improved overall diagnostic ability more so than any of the other test combinations.
A combination of the motion and provocation tests increased specificity and positive predictive values, and the FABER test had the highest of these single values. The palpation tests did not change after the SIJ block, suggesting that their accuracy cannot be determined using this method.
本研究旨在评估与作为骶髂关节功能障碍(SIJD)患者金标准评估方法的骶髂关节(SIJ)阻滞相比,运动触诊和疼痛激发试验的可靠性和有效性。
在拉苏勒·阿克拉姆医院运动与运动医学科进行了一项横断面研究。根据症状、体格检查和磁共振成像结果的综合情况,从150例患者中选出48例疑似患有SIJD的患者。疑似患有SIJD的患者接受了SIJ阻滞,并将所有体格检查的准确性与之进行比较。计算每项检查的敏感性、特异性以及阳性和阴性预测值。测量受试者工作特征曲线及受试者工作特征曲线下面积。
屈曲、外展和外旋(FABER)试验在体格检查中具有最高的特异性和阳性预测值。此外,FABER试验和大腿推压试验的联合应用比其他任何试验组合更能提高整体诊断能力。
运动试验和激发试验的联合应用提高了特异性和阳性预测值,且FABER试验在这些单一值中最高。SIJ阻滞后触诊试验没有变化,表明无法用这种方法确定其准确性。