Original Editors - Lauren Trehout
There are a number of sacroiliac joint (SIJ) mobility tests used to assess movement or asymmetry of the SIJ. SIJ dysfunction refers to misalignment or abnormal movement of the SIJ, which can cause pain in or around the SIJ.
The Stork test, also known as the Gillet Test, assesses the movement of the SIJ between the innominate and sacrum through the clinician's palpation, which may be a useful test for clinical evaluation of a subject's ability to stabilize intrapelvic motion.
The assessment of the Stork test involves palpation of the posterior superior iliac spine (PSIS). There are 2 phases to the Stork test: the stance phase and the hip flexion or swing phase.
To perform this test, the patient stands while the examiner palpates the posterior superior iliac spine (PSIS) with one thumb and palpates the base of the sacrum with the other thumb medial to the PSIS. The patient is then instructed to stand on one leg while pulling the hip of the side being palpated into 90° or more of hip flexion. The test is then repeated on the other side and compared bilaterally. The examiner should compare each side for quality and amplitude of movement.In a normally functioning pelvis, the pelvis of the side being palpated should rotate posteriorly, causing the PSIS to drop or move inferiorly. There should also be symmetry in amount of movement between both the left and right SIJ. The test is positive when the PSIS on the ipsilateral side (same side of the body) of the knee flexion moves minimally in the inferior direction, doesn’t move or is associated with pain. A positive test is an indication of sacroiliac joint hypomobility.
There is little evidence favoring that mechanical SIJ dysfunctions are related to the experience of back pain and referred pain. The range of motion in the SIJ is small, less than 4° of rotation and up to 1,6 mm of translation. It is hence difficult and doubtful to found differences in range of motion between the symptomatic and asymptomatic sides for patient with presumed SIJ pain.
- Distraction test
- Compression test
- Thigh thrust test
- Gaenslen’s test
- Sacral thrust test
The thigh thrust test, compression test, and three or more positive stressing tests showed discriminative power for diagnosing SIJ pain. 3 of 5 of the tests must be positive, whilst 1 of the 3 positive results must be Thigh Thrust or Compression.
A positive Stork test (Gillet test), combined with other positive sacroiliac mobility tests, indicates an valid impairment of mobility of the sacroiliac joint (SIJ). Springing tests, by means of which a passive mobility ("joint play") is being tested, are most valuable in dysfunction diagnostics. However, the clinical use of these clusters however has yet to been validated .Multiple studies confirm that these tests have no significance to determine SIJ dysfunction nor pain..
1 study determined that the Stork test, together with the examination of irritation points and irritation points during functional testing could asses SIJ dysfunction.
- The outcomes of individual mobility tests, including the Stork test, are not reliable and valid in diagnosing SIJ dysfunction.
- There is an average to high reliability in the assessment of the SIJ when a cluster of mobility and provocation tests are carried out
- Physical therapists can recognize an altered pattern of intrapelvic motion during the Stork Test, as well as distinguish between no relative movement and anterior rotation of the innominate bone during a Stork test
- Asymmetry in SIJ movement can also be found in asymptomatic subjects, having a .22 reliability. It is suggested not to rely solely on one test for diagnosis of SIJ dysfunction
Hungerford et al. concluded that the ability of the physiotherapist to reliably palpate and recognize an altered pattern of intrapelvic motion during Stork Test on the support side was substantiated. The ability to distinguish between no relative movement and anterior rotation of the innominate bone during a load-bearing task was good. Further research is needed to determine the validity of this test for detecting pelvic girdle dysfunction.
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