. 2016 Mar;60(1):36–46.

Table 3.

Reliability studies, PSIS palpation

Author, date	Palpatory method (bilateral unless unilateral noted)	Examiners/participants (E/P)	Reliability (ϰ, % agreement, or other statistic)	Quality. score (n/11)	Study conclusions
Potter, 1985⁸	Seated and standing, cadual aspect	E: 8 PTs P: 17 buttock pain	%=35.29 seated %=35.29 standing (interexaminer only)	4	Need for improved methods for SI palpation; PSIS palpation under the conditions of this study was unreliable.
Byfield, 1992²⁸	Standing position, aspect of PSIS not specified	E: 10 DCs & 10 students P: 2 patients, clinical status unspecified	“Horizontal spread” for DCs 1.1 (0.7) cm, for students 2.0 (0.1) cm “Vertical spread” for DCs 1.4 (0.7) cm, for students 4.5 (2.2) cm students	4	The DC’s skin marks for PSIS location were more “concentrated” than students’ marks; DCs were “reasonably” reliable.
Simmonds, 1992²⁰	Prone, not further specified	E: 20 PTs P: 20 asymp.	Intraexaminer: mean distance between UV skin marks= 8 ±5 mm Interexaminer: mean distance between UV skin marks= 20 ±13 mm	5	PSIS palpation was associated with a statistically significant low within-rater but high between-rater error.
Paydar, 1994¹⁰	Seated, caudal aspect	E: 2 DC students P: 32 asymp.	ϰ=.25 (intraexaminer) %=51.6 ϰ=.15 (interexaminer) %=46.8	2	The clinical decision on which sacroiliac joint to treat should not be based on palpatory findings alone.
Lindsay, 1995²¹	Prone, not further specified	E: 2 experienced manual therapists P: 8 skiers (unknown symptom status) Apparently dichotomous protocol	ϰ= −.10 %=50 (interexaminer only)	3	PSIS palpation failed to meet a predetermined agreement criterion of 70%; sacroiliac very unreliable.
O’Haire, 2000²³	Prone, caudal aspect	E: 10 DO students P: 10 asymp.	ϰ=.07 to .58, mean .33 %=43–94 (intraexaminer) ϰ=.04, %=51 (interexaminer only)	6	Only slight inter-examiner reliability; efforts should be made to improve levels of agreement.
Riddle, 2002¹⁸	Seated	E: 34, pairwise P: 65 pain	ϰ:=.37 %=55.6 (interexaminer only)	5	Pain provocation tests appear to have more support for identifying sacroiliac problems than sacroiliac alignment or movement tests.
Fryer, 2005²²	Prone, caudal aspect	E: 10 final year osteopathic students (5 trained) P: 10 asymp. female volunteers	ϰ=0.49 untrained, .54 trained (intraexaminer) ϰ=0.15 untrained; .08 trained %=53 trained, %=34 untrained (interexaminer)	7	Training did not improve reliability
Kim, 2007⁴	Prone, caudal aspect	E: 4, experienced P: 60 patients	Wilcoxon statistic: mean PSIS delta = .60(.60) mm (interexaminer only)	6	Palpating the PSIS with accuracy might be difficult.
Kimita, 2008²⁴	Prone, caudal aspect	E: 2 students, 2 experienced DOs P: 5 symptomatic, 4 asymp.	ϰ= −.29 to 0.39 (intraexaminer) %=11–67 ϰ= .38 to 0.35 (interexaminer) %=11–56	10	Inter-examiner reliability was low, irrespective of examiners’ years of experience.
van Kessel-Cobelens, 2008¹⁹	Seated, caudal aspect	E: 2 PTs P: Total 60 20 Control 22 w/pelvic pain, 20 wks pregnant 20 no pelvic pain, 20 weeks pregnant (interexaminer only)	Total group: ϰ=0.26, %=63 Control: ϰ=0.47, %=75 Pain: ϰ=.20, %=60 Non-pain: ϰ=0.10, %=55	7	Poor interexaminer reliability for palpation, should not be used for diagnostic purposes.
Sutton, 2012²⁷	Standing, caudal aspect, unilateral	E: 15 final year osteopathy students, 15 3^rd year, 10 exp. osteopaths P: 1 asymp. model; 5mm wedge inserted 2/3 trials (interexaminer only)	3rd year students ϰ=.025; 4^th year ϰ=.065; DOs ϰ=.058; all combined ϰ=.063	6	Inter-reliability of palpation to locate PSISs and assess levels is poor in both students and experienced osteopaths.
Suwanasri, 2014²⁵	Standing, aspect unspecified	E: PTs, number unclear P: 10 PT students	ϰ<.40	2	Inter-reliability of palpation to locate PSISs is poor.

Abbreviations: DO=Osteopath, DC=Chiropractor, PT=Physiotherapist, E=Examiner, P=Patient, ϰ=Kappa, mm=millimeter, asymp.= asymptomatic patient