A physical therapist has a barrage of tests if someone is suspected as having a sacroiliac (SI) joint dysfunction.  They can complete distraction or compression of the pelvis, the thigh thrust test, sacral thrust test, March test, palpation of the muscles and ligaments at the pelvis, and assess the alignment of the innominates.  All of these are helpful in determining if the SI joint is the problem but they are difficult to quantitatively measure change.  Mens et al. set out to come up with another clinical test to help confirm and measure SI joint dysfunction.

Their methods are as follows:

  1. Have the patient in supine with their legs straight and relaxed.
  2. The patient is asked to raise the unaffected leg about 6 inches while keeping the knee straight and then lower back down.
  3. Then complete on the affected side.
  4. The examiners assessed if the patient had any tremors in the leg during the leg raise, if there was a compensatory motion at the trunk, if the subject had any verbal and nonverbal emotional expression during the task, and the patient was asked if they noticed any difference between the sides.
    1. The patient was scored from 0-3
      1. 0 = The patient feels no restriction
      2. 1 = The patient reports decreased ability to raise the leg but the examiner assesses no signs of impairment
      3. 2 = The patient reports decreased ability to raise the leg and the examiner examines signs of impairment
      4. 3 = The patient is unable to raise the leg.
    2. A difference in score of 2 or more was considered significant
  5. Then the patient completed the tasks again with a belt fastened either just below the Anterior Inferior Iliac Spines or at the Pubic Symphysis and reassessed for change in ability to complete the task.

To further provide measurable values to reassess as the patient improves I would suggest measuring the hip flexion range of motion if the patient cannot complete the 6 inch leg raise with or without the fastened belt.  Also, you can manual muscle test the legs with and without the fastened belt and document the strength change if the patient can complete the 6 inch leg raise to observe and measure the difference.  Just be aware of the patient’s irritability prior to completing a graded resistance to the leg to avoid flaring up the patient’s symptoms.

If you are having difficulty visualize the test, please watch the video below.

 Reference:

Mens J, Vleeming A, Snijders CJ, Stam HJ, Ginai AZ. The active straight leg raising test and mobility of the pelvic joints.  Eur Spine J. 1999; 8:468-473.

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