PROCEDURE

The study was approved by the scientific research committee and Time bound Ethics Committee of K.M.C Mangalore.The subjects diagnosed to have low back pain, by the physician referred to physiotherapy department were given informed consent and purpose of the study was explained. Once informed consent was obtained, the subject was screened by the investigator for inclusion and exclusion criteria. The subjects who fulfilled the inclusion criteria were taken as case group. Similarly asymptomatic individuals who fulfilled their inclusion criteria were taken as control group. General musculoskeletal examination was performed for the case group and both the case and control group subjects were assessed for pelvic asymmetry. The total duration taken for the procedure was 20-30 min.

Measurement of pelvic asymmetry:

The PALM instrument, (Performance Attainment Associates, St. Paul, MN) which combines the features of a calliper and an inclinometer, was used to measure the pelvic asymmetry.

Levelness of the floor was established with a carpenter’s level and 2 pieces of tape spaced 15 cm apart were placed on the floor. The tape strips marked the location on the floor where subjects would position their feet and standing in a fully erect posture with no bending of the ankles, knees, hips, or spine, with folding their arms across the chest.

To measure the differences in Posterior Superior Iliac Spines (PSIS) level the examiner palpated the most prominent aspect of PSIS from behind and placed the PALM calipers.The inclinometer ball was designed to move towards the shorter side. The extent of deflection was recorded in the record sheet.

Then, the examiner placed the PALM at prominent point of Anterior Superior Iliac Spines (ASIS) from front for measuring ASIS differences and standing laterally for measuring one side innominate tilt by placing PALM calipers between ASIS and PSIS of the same side and deflection was recorded as before . During the procedure subjects were instructed to take a deep breath in, exhale, and to wait to inhale again until after the measurement was taken.

The subjects with pelvic asymmetry were not taken for further motion palpation tests.

Motion palpation tests:

Four motion palpation tests were performed in diagnosing SIJ aberrant motion. Reliability for cluster of two or three out of four tests was found to be substantial. The presence of asymmetry or positive motion palpation tests indicated SIJ dysfunction, which was tested on both case and control groups. The results were recorded in a record sheet .