Intraexaminer and Interexaminer Reproducibility of the Downing Test for Sacroiliac Joint Evaluation of Symptomatic and Asymptomatic Individuals

• Published in: Journal of chiropractic medicine 2019-09, Vol.18 (3), p.163-170
• Main Authors: Lima, Pedro O.P., Melo, Wenya P.X., Bezerra, Márcio A., Almeida, Gabriel P.L., Nunes, Ana Carla L., Oliveira, Rodrigo R.
• Format: Article
• Language: English
• Subjects: Hip Joint; Low Back Pain; Original Research; Physical Examination; Range of Motion, Articular; Sacroiliac Joint
• ISSN: 1556-3707; 1556-3715
• DOI: 10.1016/j.jcm.2018.11.007

This study aimed to assess the intraexaminer and interexaminer reproducibility of the Downing test in sacroiliac joint evaluation in symptomatic and asymptomatic individuals. A reliability study was conducted with a test–retest design in 54 college students of both sexes. To assess the intraexaminer reproducibility, each participant was evaluated twice by the same examiner with a 7-day interval, and to assess the interexaminer reproducibility, each participant was evaluated by 2 examiners. Of the 54 participants included in the study, 18 (33.3%) were asymptomatic and 36 (66.7%) were symptomatic; a total of 108 sacroiliac joints were evaluated. Sacroiliac joint diagnosis based on the Downing test presented low intraexaminer reproducibility in all participants (κ = 0.12, 95% confidence interval [CI] 0.03-0.22), in asymptomatic individuals (κ = 0.18, 95% CI 0.02-0.34), and in symptomatic individuals (κ = 0.28, 95% CI 0.17-0.39). The interexaminer reproducibility also was low in all participants (κ = 0.18, 95% CI 0.09-0.27), in asymptomatic individuals (κ = 0.22, 95% CI 0.15-0.37), and in symptomatic individuals (κ = 0.16, 95% CI 0.05-0.27). The standard error of the measurement values were not lower than smallest detectable change values considering a CI of 95% for all participants. For this group of asymptomatic and symptomatic participants, the reproducibility of the Downing test was poor. The clinical utility of this test used in isolation is not supported by the present study.