Article

OBJECTIVE: To test the interrater reliability of examiners performing the prone
instability test (PIT), a clinical test proposed to identify lumbar shear
instability. DESIGN: Cross-sectional test-retest design examining individuals
with mechanical low back pain (LBP). SETTING: University-based musculoskeletal
analysis laboratory. PARTICIPANTS: Individuals (N=30) with mechanical LBP
recruited from community sources in a metropolitan region. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Repeated measures of a clinical examination
test proposed to identify lumbar shear instability. RESULTS: Interrater
reliability of examiners' judgments of PIT results were indexed with percentage
of agreement and kappa statistic. Examiners obtained 63% agreement and kappa of
.10 (95% confidence interval, -.27 to .47). Adjusted kappa values based on
prevalence and bias indexes were calculated to evaluate the effect on kappa. The
prevalence index associated with examiner judgments of the PIT was .43, and bias
index was .03. The prevalence-adjusted bias-adjusted kappa value was slightly
higher than the unadjusted kappa value (kappa=.27; 95% confidence interval, -.08
to .61). CONCLUSIONS: Results of our study are not consistent with those of
previous studies examining the reliability of therapists performing the PIT. We
conclude that examiners do not attain acceptable interrater reliability when
performing procedures for the PIT based on the information currently provided in
the literature. Based on our experience, we suggest further exploration,
standardization, and clarification of procedural details to improve therapists'
ability to conduct the PIT on individuals with LBP.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS