Adrian Kmita and Nicholas P. Lucas
The purpose of this study was to investigate the intra-examiner and inter-examiner reliability of physical examination to identify asymmetry of selected anatomical landmarks indicative of pelvic somatic dysfunction in subjects with and without low back pain. Four examiners (two students, two osteopaths) examined a sample of symptomatic and asymptomatic subjects for symmetry of anatomical landmarks indicative of pelvic somatic dysfunction. Two assessments of symmetry and alignment of the posterior superior iliac spine, sacral sulcus, sacral inferior lateral angle in posterior–anterior and inferior–superior directions, anterior superior iliac spine, and medial malleoli were performed on every subject by all four examiners. The reliability of physical examination for anatomical landmarks indicative of pelvic somatic dysfunction was generally found to be low. Differences between the reliability of experienced osteopaths and final year osteopathy students were negligible.
This study suggests that the identification of asymmetry of selected anatomical landmarks indicative of pelvic somatic dysfunction in subjects with and without low back pain do not have good inter and intra-rater reliability and therefore may not be a good clinical measure of dysfunction.
International Journal of Osteopathic Medicine, 2008, 11(1),