• Ulla Levin and Christina H Stenström.
• Division of Physiotherapy, Neurotec Department, Karolinska Institutet, 141 83 Huddinge, Stockholm 23100, Sweden. ulla.levin@neurotec.ki.se
• Clin Biomech (Bristol, Avon). 2003 Nov 1; 18 (9): 821-6.

ObjectiveThe present aim was to investigate whether applied force and time interval of force exposure during the sacroiliac distraction test could discriminate subjects with sacroiliitis pain from healthy subjects.DesignThe study was a methodological one using force plates sensing three orthogonal forces.BackgroundStudies evaluating the validity of sacroiliac joint tests show conflicting results. To our knowledge, no previous studies have evaluated force recording combined with pain reports.MethodsEleven subjects with sacroiliitis and 11 healthy subjects were examined with distraction test once by each of three physiotherapists. The subjects indicated any pain by pressing a button giving a mark in the data collection.ResultsThe magnitude of the total force vector was significantly smaller (P<0.05) and the time interval was significantly shorter (P<0.05) in the sacroiliitis group, although almost 20 s could elapse before pain was provoked. The sensitivity of the test was 0.55 calculated for all physiotherapists involved, and varied between them, range 0.55-0.82. The specificity was 1.0.ConclusionsThe results support the advantage of force and time recording during the distraction test as a technique for evaluating pain. Further investigation is needed on whether the velocity of force application, the ability to maintain the same pressure and the bilateral distribution of force on the sacroiliac joints influence the sensitivity.RelevanceThere is a need for objective evaluation methods in manual tests that are easy to perform. Recording force and its time interval may be a step towards standardising pain-provocation sacroiliac joint tests.

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