Inter-examiner reliability of four static palpation tests used for assessing pelvic dysfunction.

In muscle energy technique (MET), palpation is an important tool aimed at detecting asymmetry and selecting interventions. The aim of this study was to test the inter-examiner reliability of static palpation of the transverse processes of L5 (L5), sacral sulci (SS), inferior lateral angles of the sacrum (ILA), and the medial malleoli (MM) in a clinical setting. Twenty-five participants, aged 18-78 years, with low back pain and/or sacroiliac pain with or without radiating pain to the knee, were independently examined by two experienced physiotherapists. For L5, SS, ILA, the proportion of observed agreement was 40-44% and the kappa coefficient 0.11 (SE=0.12) to 0.17 (SE=0.10). For MM, the observed agreement was 52% and the kappa coefficient 0.28 (SE=0.15). Differences in palpation technique seem to be the most likely source of the low inter-examiner reliability in this study. For clinical practise, continued use of these tests as methods for detecting asymmetry and selecting interventions is of doubtful utility.