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Chiropractic Journal of Australia : CJA March 2012
7 Chiropractic Journal of Australia Volume 42 Number 1 March 2012 DISCUSSION Agreement between outcome measures was poor for both stances with both observation methods. In addition, the directions of change between the stances were not symmetrical. It might be expected that if the majority of innominate rotation occurred on ‘toe off’, subjects who had a positive test result from Stance t (standing on two feet) would be likely to have a negative result from Stance o (standing with most of the body weight on one foot). However, this was not the case when OM1 (only movement of the thumb on PSIS being noted) was used. It was the case when OM2 (the distance between the PSIS and S2 thumbs being noted) was used. Only three subjects had a change of result in the anticipated direction using OM1 whereas, 27 subjects changed in the anticipated direction using OM2. These fndings indicate that movement of the sacrum was more likely to occur on the initial weight transfer than movement of the innominate. This was supported by the good agreement between the two observation methods once the majority of body weight had been transferred to one foot (Stance o). In addition, directions of change between the methods were symmetrical. The distance between the thumbs was compared at baseline for the two stances. No relationship between the change in baseline distance between the stances and outcome was found. In terms of subject balance, Stance o was used because it was as close to ‘toe off’ as was practical. However, subjects may have predisposed themselves to a positive movement of the PSIS thumb on the lift by their weight distribution and pelvic placement when standing on one foot. This was not refected in a change in distance between the thumbs. Although the stork test is a palpation test where movement is interpreted as taking place under the PSIS thumb, the pictorial record showed otherwise. Movement occurred under the S2 and PSIS thumbs independently or together. The signifcantly higher positive proportion of results from Stance t when OM2 was used suggests that sacral movement could be signifcant even though the tester perceives movement as being in the innominate. In summary, no conclusions could be made about sacral and innominate movement in the stork test between the stances, except that observation method infuenced stork test outcome, as did stance. Results suggest that further investigation of sacral/innominate movement, weight displacement and stance is warranted. ACKNOWLEDGEMENTS We thank Laurinda Bailey, Pat McLeod and Nigel Lewis for studio preparation and videoing the tests. We thank Diana Jaffray for her illustrations. REFERENCES 1. Jacob HAC, Kissling RO. The mobility of the sacroiliac joints in healthy volunteers between 20 and 50 years of age. Clin Biomech 1995; 10(1): 352-61. 2. Snijders CJ, Vleeming A, Stoeckart R. Transfer of lumbosacral load to iliac bones and legs Part 1: Biomechanics of self-bracing of the sacroiliac joints and its signifcance for treatment and exercise. Clin Biomech 1993; 8: 285-94. 3. Curnow D, Cobbin D, Wyndham J. Reliability of the Stork Test: Is Starting Stance Important? Chiropr J Aust 2010; 40: 137-41. 4. Hungerford BA, Gilleard W. Sacroiliac joint angular rotation during the stork test and hip drop test in normal subjects: pilot study results. Proceedings of the 3rd Interdisciplinary World Congress on Low Back and Pelvic Pain 1998 Nov. 19-21; Vienna: 332-4. 5. Hungerford BA, Gilleard W, Lee D. Altered patterns of pelvic bone motion determined in subjects with posterior pelvic pain using skin markers. Clin Biomech 2004; 19: 456-64. 6. Hungerford BA, Gilleard W, Hodges P. Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine 2003; 28(14): 1593-1600. 7. Richardson CA, Snijders CJ, Hides JA, Damen L, Pas MS, Storm J. The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine 2002; 27(4): 399-405 OBSERVATION METHODS STORK TEST CURNOW • COBBIN • WYNDHAM
CJA June 2012