Correlation of Lateral Pelvic Sway to Variances of Pain along the Inguinal Ligaments: A Pilot Study

Thompson DM, Vrugtman RP, Johnson KM, Dicks SK, Unger-Boyd MProceedings of the ACC Conference X, Journal of Chiropractic EducationSpr 2003; 17(1): 76

INTRODUCTION: Sacro-occipital technique utilizes several clinical tests within its protocols to determine the physical status of a patient. Two of the indicators to identify a category II subject are increased lateral pelvic sway with eyes closed and held inspiration, and the arm fossa test, which challenges the inguinal ligaments. As a result of issues relating to intra– and interexaminaer reliability of the arm fossa test, this research project tested a modification of the arm fossa test. To provide specific measurement data, the authors chose to challenge the inguinal ligaments with a pressure algometer to the point of pain. The purpose of the study was to determine if there is a correlation between increased lateral pelvic sway greater than 1.2 cm (0.5 inch) and the asymmetry of pressure needed to induce pain along areas of the paired inguinal ligaments.

METHODS: Subjects consisted of a single cohort of male and female chiropractic students between the ages of 20 and 40. Observation for increased lateral sway greater then 1.2 cm with eyes open and then with eyes closed, both with held inspiration, was determined with a postural analyzer (Foot Levelers). The subjects were then tested, to a maximum of 40 psi with a pressure algometer, to the point of pain along the inguinal ligaments. The inguinal ligament was divided into upper and lower fossae.

RESULTS: Forty-seven subjects were tested. Five subjects were excluded due to the inability to produce pain below 40 psi in at least one of the fossae areas. Group 1 (n=23) had increased lateral pelvic sway with eyes open and eyes closed. Group 2 (n=11) had increased lateral pelvic sway with eyes closed but not with eyes open. Group 3 (n=6) did not have increased lateral pelvic sway with eyes open or with eyes closed. Group 4 (n=2) had increased lateral pelvic sway with eyes open but not with eyes closed. There were no significant differences of the pressure needed to induce pain within or between groups.

CONCLUSION: We did not find significant and meaningful differentiation among the required pressure to produce pain in the inguinal ligaments. As a result, we could not establish a relationship between increased lateral pelvic sway and the asymmetry of pressure needed to produce pain along the inguinal ligaments. However, the authors believe that there are some important findings from this pilot study. For example, since the sample sizes within some of the sway groups were to small of proper analysis, these data provide a baseline group percentage to calculate sample size with the power needed for similar studies. Also, since there was not an inclusion criteria for back pain within our subjects, the findings of the inguinal ligament mean pressures can begin to provide a baseline comparison for any further testing with known symptomatic low back or pelvic pain subjects.

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