Stork Test: Difference between revisions

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The patient raises one knee up, so that the hip and knee are flexed to 90 degrees. Whilst this is done, assess the posterior rotation of the innominate on the side of the lifted knee. Then ask the patient to raise the other knee up whilst assessing the anterior rotation of the innominate on single leg support side. The direction of the bone motion is palpated as the contralateral foot is lifted off the ground.<ref><span style="line-height: 1.5em;">Jeffrey Gross, Wiley-Blackwell, Musculoskeletal Examination 3rd edition, 2009, p. 114.</span></ref>
The patient raises one knee up, so that the hip and knee are flexed to 90 degrees. Whilst this is done, assess the posterior rotation of the innominate on the side of the lifted knee. Then ask the patient to raise the other knee up whilst assessing the anterior rotation of the innominate on single leg support side. The direction of the bone motion is palpated as the contralateral foot is lifted off the ground.<ref><span style="line-height: 1.5em;">Jeffrey Gross, Wiley-Blackwell, Musculoskeletal Examination 3rd edition, 2009, p. 114.</span></ref>


<br>In a normally functioning pelvis, the pelvis of the side being palpated should rotate posteriorly, causing the PSIS to drop or move inferiorly. 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.<ref>Magee DJ. Orthopedic physical assessment. 5th ed. St. Louis: Saunders, 2008. (LOE 1A)</ref>{{#ev:youtube|dvhvKXnXAac}}<br> <br>
<br>In a normally functioning pelvis, the pelvis of the side being palpated should rotate posteriorly, causing the PSIS to drop or move inferiorly. There shoulder 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.<ref>Magee DJ. Orthopedic physical assessment. 5th ed. St. Louis: Saunders, 2008. (LOE 1A)</ref>{{#ev:youtube|dvhvKXnXAac}}<br><br>
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The relationship between the SIJ and low back pain has been a subject of debate. Some researchers regard SIJ pain as a major contributor to the problem of low back pain while others regard it as unimportant or irrelevant. It is nowadays generally accepted that about 13&nbsp;% of patients with chronic low back pain have the origin of pain confirmed as the SIJ.<ref name=":1" /><br>There are two clinical perspectives to consider. The first is the SIJ as a load-transferring mechanical junction between the pelvis and the spine that may cause either the SIJ or other structures to produce painful stimuli. The second perspective considers the SIJ as a source of pain.
The first perspective proposes that the joint is malfunctioning. Therefore the word dysfunction is commenly used to encapsulate the complexity of abberations believed to occur. The evidence favoring that mechanical SIJ dysfunctions are related to the experience of back and referred pain is less than convincing. The range of motion in the SIJ is small, less than 4° of rotation and up to 1,6 mm of translation. Hence in patients presumed to have an SIJ source of pain it is difficult and doubtful to found differences in range of motion between the symptomatic and asymptomatic sides.<ref name=":1" />
Due to the poor reliability and validity of many SIJ mobility assesment tests. And with an increased understanding of the role of the pelvis in load transfer has shifted the focus of clinical assessment procedures for SIJ function from SIJ mobility testing to functional assessment procedures that test the ability of the pelvis to maintain stability during load transfer between the spine and the lower limbs.<ref name=":1" />
An investigation of motion between the innominate bone and the sacrum on the side of single-leg support during a standing hip flexion movement revealed that the innominate bone on the side of single-leg support rotated posteriorly relative to the sacrum in subjects who were healthy. This pattern was altered reliably in the presence of PGP. Here the innominate bone rotated anteriorly relative to the sacrum, which was an indication of a failure of the self-bracing mechanism to maintain the SIJ in its closed pack position. <br>
== Evidence ==
== Evidence ==
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<div>


Several studies concluded that not a single test but a cluster of tests should be used to confirm diagnosis. Other sacroiliac pain provocation tests to evaluate the mobility of the sacroiliac joint are the Distraction test, Compression test, Thigh thrust test, Gaenslen’s test and Sacral thrust test.<ref>KJ Stuber. Specificity, sensitivity, and predictive values of clinical tests of the sacroiliac joint: a systematic review of the literature. J Can Chiropr Assoc. 2007; 51(1): 30-41 ( LOE 1A)</ref><br>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<ref>Grgić V.; The sacroiliac joint dysfunction: clinical manifestations, diagnostics and manual therapy; Lijec Vjesn. 2005 Jan-Feb;127(1-2):30-5. (LOE 3A)</ref>.&nbsp;;The clinical use of these clusters however has yet to been validated .Multiple studies confirm that these tests have no significance to determine SIK dysfunction nor pain.<ref>Hungerford B, Evaluation of the ability of physical therapists to palpate intrapelvic motion with the Stork test on the support side; Physical Therapy; 2007; Jul;87(7):879-87. (LOE 2A)</ref><ref>van der Wurff P, Hagmeijer RH, Meyne W., “Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability.”, Man Ther. 2000 Feb;5(1):30-6. (1A)</ref><ref>Riddle DL, Freburger JK., “Evaluation of the presence of sacroiliac joint region dysfunction using a combination of tests: a multicenter intertester reliability study.”, PHYS THER., 2002 Aug; 82(8):772-782. (2B)</ref>.1 study determined that the stork test, together with the examniation of irritation points and irritation points during functinal testing could asses SIJ dysfunction.Therefore, the physical therapy management for this dysfunction was Mobilizing techniques without impulse as well as manipulative techniques with high-velocity impulses were applied to resolve the dysfunction.<ref>Galm R, Fröhling M, Rittmeister M, Schmitt E., “Sacroiliac joint dysfunction in patients with imaging-proven lumbar disc herniation.”, Eur Spine J. 1998;7(6):450-3. (1B)</ref>  
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.<ref name=":1" />


The thigh thrust test, compression test, and three or more positive stressing tests showed discriminative power for diagnosing SI joint pain. 3 of 5 must be positive (Thigh Thrust, Compression, Gaenslen, FABER, Distraction). 1 of 3 positive results must be Thigh Thrust or Compression.<ref>Karolina M. Szadek, et al.; Diagnostic validity of criteria for sacroiliac joint pain: a systematic review.; The Journal of Pain: Official Journal of the American Pain Society 10, no. 4 (April 2009): 354-368. (LOE 1A)</ref>  
Several studies concluded that not a single test but a cluster of tests should be used to confirm diagnosis. The recommended [[Sacroiliac Joint Special Test Cluster|SIJ Test Item Cluster]] are:<ref>KJ Stuber. Specificity, sensitivity, and predictive values of clinical tests of the sacroiliac joint: a systematic review of the literature. J Can Chiropr Assoc. 2007; 51(1): 30-41 ( LOE 1A)</ref>
# 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.<ref>Karolina M. Szadek, et al.; Diagnostic validity of criteria for sacroiliac joint pain: a systematic review.; The Journal of Pain: Official Journal of the American Pain Society 10, no. 4 (April 2009): 354-368. (LOE 1A)</ref>


Manual High-Velocity-Low-Amplitude (HVLA) manipulation is an efficient method of treatment for patients with sacroiliac dysfunction. In a study. improvements in pain (VAS-scale) and function were detected 2 days and 1 month after a single session<ref>Kamali F, Shokri E., “The effect of two manipulative therapy techniques and their outcome in patients with sacroiliac joint syndrome.”, Journal of Bodywork &amp; Movement Therapies, 2012 16, 29e35. (1B)</ref>. No consensus is found about the underlying mechanisms of treating SIJ dysfunctions. A few plausible explanations for improvements are increased ROM, normalization of muscle tone and disrupting articular adhesions.<br>The following is a description of the HVLA manipulation technique used in the LOE 1B study. The patient is supine and the therapist stands contralateral to the side which is to be manipulated (e.g. right) (Fig. 2). The patient is passively moved into side bending toward the side to be manipulated. The patient should inter-lock their fingers behind their head. The therapist passively rotates the patient, and then delivers a quick thrust to the Anterior Superior Iliac Spine (ASIS) in a posterior and inferior direction.<ref>Cleland, J., Fritz, J., et al., “Comparison of the effectiveness of three manual physical therapy techniques in a subgroup of patients with low back pain who satisfy a clinical prediction rule: a randomized clinical trial.” Spine (2009)34 (25), 2720. (1B)</ref><br>
<br>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<ref>Grgić V.; The sacroiliac joint dysfunction: clinical manifestations, diagnostics and manual therapy; Lijec Vjesn. 2005 Jan-Feb;127(1-2):30-5. (LOE 3A)</ref>.&nbsp;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.<ref>Hungerford B, Evaluation of the ability of physical therapists to palpate intrapelvic motion with the Stork test on the support side; Physical Therapy; 2007; Jul;87(7):879-87. (LOE 2A)</ref><ref>van der Wurff P, Hagmeijer RH, Meyne W., “Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability.”, Man Ther. 2000 Feb;5(1):30-6. (1A)</ref><ref>Riddle DL, Freburger JK., “Evaluation of the presence of sacroiliac joint region dysfunction using a combination of tests: a multicenter intertester reliability study.”, PHYS THER., 2002 Aug; 82(8):772-782. (2B)</ref>.


<br>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. Although further research is needed to determine the validity of this test for detecting pelvic girdle dysfunction.<ref name=":1" />
1 study determined that the Stork test, together with the examniation of irritation points and irritation points during functinal testing could asses SIJ dysfunction.<ref>Galm R, Fröhling M, Rittmeister M, Schmitt E., “Sacroiliac joint dysfunction in patients with imaging-proven lumbar disc herniation.”, Eur Spine J. 1998;7(6):450-3. (1B)</ref>
== Reliability  ==
== Reliability  ==
[[Image:T6-jcca51 1p030.png|200x200px|right]]
* The outcomes of individual mobility tests, including the Gillet’s test, are not reliable in diagnosing SIJ dysfunction.<ref>van der Wurff P, Hagmeijer RH, Meyne W., “Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability.”, Man Ther. 2000 Feb;5(1):30-6. (1A)</ref>
# The outcomes of individual mobility tests, including the Gillet’s test, are not reliable in diagnosing SIJ dysfunction.<ref>van der Wurff P, Hagmeijer RH, Meyne W., “Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability.”, Man Ther. 2000 Feb;5(1):30-6. (1A)</ref>
* The outcomes of individual mobility tests, including the Gillet’s test, are not valid in diagnosing SIJ dysfunction<ref>van der Wurff P, Hagmeijer RH, Meyne W., “Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability.”, Manual Therapy, 2000; 5(2):89±96. (1A)</ref>
# The outcomes of individual mobility tests, including the Gillet’s test, are not valid in diagnosing SIJ dysfunction<ref>van der Wurff P, Hagmeijer RH, Meyne W., “Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability.”, Manual Therapy, 2000; 5(2):89±96. (1A)</ref>
* There is an average to high reliability in the assessment of the SIJ when a cluster of mobility and provocation tests are carried out<ref>Arab AM, Abdollahi I, Joghataei MT, Golafshani Z, Kazemnejad A.,”Inter- and intra-examiner reliability of single and composites of selected motion palpation and pain provocation tests for sacroiliac joint.”, Man Ther. 2009 Apr;14(2):213-21. (1B)</ref>
# A cluster of mobility tests and provocation tests have an average to high reliability in the assessment of the SIJ<ref>Arab AM, Abdollahi I, Joghataei MT, Golafshani Z, Kazemnejad A.,”Inter- and intra-examiner reliability of single and composites of selected motion palpation and pain provocation tests for sacroiliac joint.”, Man Ther. 2009 Apr;14(2):213-21. (1B)</ref>
* 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<ref>Hungerford B, Evaluation of the ability of physical therapists to palpate intrapelvic motion with the Stork test on the support side; Physical Therapy; 2007; Jul;87(7):879-87. (LOE 2A)</ref>
# A single manual HVLA manipulation session is proven to reduce pain and mobility impairment for people suffering from SIJ dysfunction<ref>Arab AM, Abdollahi I, Joghataei MT, Golafshani Z, Kazemnejad A.,”Inter- and intra-examiner reliability of single and composites of selected motion palpation and pain provocation tests for sacroiliac joint.”, Man Ther. 2009 Apr;14(2):213-21. (1B)</ref>
* According to a study, The Gillet test, as performed in this study, does not appear to be reliable.<ref>Wilco Meijne, Katinka van Neerbos, Geert Aufdemkampe, Peter van der Wurff d, Intraexaminer and interexaminer reliability of the Gillet test, Journal of Manipulative &amp; Physiological Therapeutics Volume 22, Issue 1, Pages 4–9, January 1999. (LOE 1B)</ref>
# Physical therapists can recognize an altered pattern of intrapelvic motion during the Stork Test. Physical therapists can distinguish between no relative movement and anterior rotation of the innominate bone during a Stork test<ref>Hungerford B, Evaluation of the ability of physical therapists to palpate intrapelvic motion with the Stork test on the support side; Physical Therapy; 2007; Jul;87(7):879-87. (LOE 2A)</ref>
# According to a study, The Gillet test, as performed in this study, does not appear to be reliable.<ref>Wilco Meijne, Katinka van Neerbos, Geert Aufdemkampe, Peter van der Wurff d, Intraexaminer and interexaminer reliability of the Gillet test, Journal of Manipulative &amp; Physiological Therapeutics Volume 22, Issue 1, Pages 4–9, January 1999. (LOE 1B)</ref>
<br>The Diagnostic Accuracy of the Gillet test (stork test) is described below:<br>Sensitivity is the proportion of people with a positive test result who have the target disorder, essentially true positives.<ref name=":2">KJ Stuber. Specificity, sensitivity, and predictive values of clinical tests of the sacroiliac joint: a systematic review of the literature. J Can Chiropr Assoc. 2007; 51(1): 30-41 ( LOE 1A)</ref>


<br>Specificity is the proportion of people with a negative test result who do not have the target disorder, essentially true negatives.<ref name=":2" />  
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.<ref name=":1" />


[[Image:4.jpg|250x250px|right]]<br>
<br>The Diagnostic Accuracy of the Gillet test (stork test) is described below:<br>Sensitivity is the proportion of people with a positive test result who have the target disorder, essentially true positives.<ref name=":2">KJ Stuber. Specificity, sensitivity, and predictive values of clinical tests of the sacroiliac joint: a systematic review of the literature. J Can Chiropr Assoc. 2007; 51(1): 30-41 ( LOE 1A)</ref>


<br>  
<br>Specificity is the proportion of people with a negative test result who do not have the target disorder, essentially true negatives.<ref name=":2" /><br>  


== References  ==
== References  ==

Revision as of 15:25, 27 August 2018

Original Editors - Lauren Trehout

Top Contributors - Jetse De Proft, Lauren Trehout, Yvonne Yap, Uchechukwu Chukwuemeka, Adam Vallely Farrell, Maram Salem, Kim Jackson, Rachael Lowe, Wanda van Niekerk, Ahmed M Diab, George Prudden and Tarina van der Stockt  

Purpose[edit | edit source]

There are a number of sacroiliac joint (SIJ) mobility tests used to assess movement or asymmetry of the SIJ.[1] SIJ dysfunction refers to misalignment or abnormal movement of the SIJ, which can cause pain in or around the SIJ.[2]

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.[3]

Technique[edit | edit source]

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.

The therapist places one thumb directly on the PSIS and the other thumb is placed medial to the PSIS, on the base of the sacrum.

The patient raises one knee up, so that the hip and knee are flexed to 90 degrees. Whilst this is done, assess the posterior rotation of the innominate on the side of the lifted knee. Then ask the patient to raise the other knee up whilst assessing the anterior rotation of the innominate on single leg support side. The direction of the bone motion is palpated as the contralateral foot is lifted off the ground.[4]


In a normally functioning pelvis, the pelvis of the side being palpated should rotate posteriorly, causing the PSIS to drop or move inferiorly. There shoulder 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.[5]


Evidence[edit | edit source]

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.[3]

Several studies concluded that not a single test but a cluster of tests should be used to confirm diagnosis. The recommended SIJ Test Item Cluster are:[6]

  1. Distraction test
  2. Compression test
  3. Thigh thrust test
  4. Gaenslen’s test
  5. 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.[7]


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[8]. 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.[9][10][11].

1 study determined that the Stork test, together with the examniation of irritation points and irritation points during functinal testing could asses SIJ dysfunction.[12]

Reliability[edit | edit source]

  • The outcomes of individual mobility tests, including the Gillet’s test, are not reliable in diagnosing SIJ dysfunction.[13]
  • The outcomes of individual mobility tests, including the Gillet’s test, are not valid in diagnosing SIJ dysfunction[14]
  • There is an average to high reliability in the assessment of the SIJ when a cluster of mobility and provocation tests are carried out[15]
  • 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[16]
  • According to a study, The Gillet test, as performed in this study, does not appear to be reliable.[17]

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.[3]


The Diagnostic Accuracy of the Gillet test (stork test) is described below:
Sensitivity is the proportion of people with a positive test result who have the target disorder, essentially true positives.[18]


Specificity is the proportion of people with a negative test result who do not have the target disorder, essentially true negatives.[18]

References[edit | edit source]

  1. ↑ Sturesson, Bengt Md, Uden Alf MD, PhD, Vleeming, Andry PhD., “A radiostereometric analysisof movements of the sacroiliac joints during the standing hip flexion test.”, Spine, 2000; 25(2):214. (2B)
  2. ↑ Daniel L Riddle, Janet K Freburger and North American Orthopaedic Rehabilitation Research Network, “Evaluation of the presence of sacroiliac joint region dysfunction using a combination of test: a multicenter intertester reliability study.” , 2002. Journal of the amercian Physical Therapy association, 2002; 87:879-887. (2B)
  3. ↑ 3.0 3.1 3.2 Barbara A Hungerford et al., “Evaluation of the ability of physical therapists to palpate intrapelvic motion with the stork test on the support side.”, Journal of American Physical therapy Association, 2007; 87:879-887. (2B)
  4. ↑ Jeffrey Gross, Wiley-Blackwell, Musculoskeletal Examination 3rd edition, 2009, p. 114.
  5. ↑ Magee DJ. Orthopedic physical assessment. 5th ed. St. Louis: Saunders, 2008. (LOE 1A)
  6. ↑ KJ Stuber. Specificity, sensitivity, and predictive values of clinical tests of the sacroiliac joint: a systematic review of the literature. J Can Chiropr Assoc. 2007; 51(1): 30-41 ( LOE 1A)
  7. ↑ Karolina M. Szadek, et al.; Diagnostic validity of criteria for sacroiliac joint pain: a systematic review.; The Journal of Pain: Official Journal of the American Pain Society 10, no. 4 (April 2009): 354-368. (LOE 1A)
  8. ↑ Grgić V.; The sacroiliac joint dysfunction: clinical manifestations, diagnostics and manual therapy; Lijec Vjesn. 2005 Jan-Feb;127(1-2):30-5. (LOE 3A)
  9. ↑ Hungerford B, Evaluation of the ability of physical therapists to palpate intrapelvic motion with the Stork test on the support side; Physical Therapy; 2007; Jul;87(7):879-87. (LOE 2A)
  10. ↑ van der Wurff P, Hagmeijer RH, Meyne W., “Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability.”, Man Ther. 2000 Feb;5(1):30-6. (1A)
  11. ↑ Riddle DL, Freburger JK., “Evaluation of the presence of sacroiliac joint region dysfunction using a combination of tests: a multicenter intertester reliability study.”, PHYS THER., 2002 Aug; 82(8):772-782. (2B)
  12. ↑ Galm R, Fröhling M, Rittmeister M, Schmitt E., “Sacroiliac joint dysfunction in patients with imaging-proven lumbar disc herniation.”, Eur Spine J. 1998;7(6):450-3. (1B)
  13. ↑ van der Wurff P, Hagmeijer RH, Meyne W., “Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability.”, Man Ther. 2000 Feb;5(1):30-6. (1A)
  14. ↑ van der Wurff P, Hagmeijer RH, Meyne W., “Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability.”, Manual Therapy, 2000; 5(2):89±96. (1A)
  15. ↑ Arab AM, Abdollahi I, Joghataei MT, Golafshani Z, Kazemnejad A.,”Inter- and intra-examiner reliability of single and composites of selected motion palpation and pain provocation tests for sacroiliac joint.”, Man Ther. 2009 Apr;14(2):213-21. (1B)
  16. ↑ Hungerford B, Evaluation of the ability of physical therapists to palpate intrapelvic motion with the Stork test on the support side; Physical Therapy; 2007; Jul;87(7):879-87. (LOE 2A)
  17. ↑ Wilco Meijne, Katinka van Neerbos, Geert Aufdemkampe, Peter van der Wurff d, Intraexaminer and interexaminer reliability of the Gillet test, Journal of Manipulative & Physiological Therapeutics Volume 22, Issue 1, Pages 4–9, January 1999. (LOE 1B)
  18. ↑ 18.0 18.1 KJ Stuber. Specificity, sensitivity, and predictive values of clinical tests of the sacroiliac joint: a systematic review of the literature. J Can Chiropr Assoc. 2007; 51(1): 30-41 ( LOE 1A)
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