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Related Experiment Videos

Interrater reliability of lumbar accessory motion mobility testing

J Binkley1, P W Stratford, C Gill

  • 1Department of Physical Therapy, North Georgia College, Dahlonega 30597, USA.

Physical Therapy
|September 1, 1995
PubMed
Summary

Physical therapists show poor agreement when testing lumbar spine accessory motion. This unreliability in posterior-anterior (P-A) mobility testing may impact clinical decisions for low back pain patients.

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Area of Science:

  • Orthopedics
  • Physical Therapy
  • Spinal Biomechanics

Background:

  • Low back pain is a prevalent condition requiring accurate physical examination.
  • Accessory motion mobility testing is a common physical therapy assessment for the lumbar spine.

Purpose of the Study:

  • To evaluate the interrater reliability of accessory motion mobility testing of the lumbar spine.
  • To assess the agreement among physical therapists in identifying spinal levels and mobility findings.

Main Methods:

  • Six orthopedic physical therapists assessed posterior-anterior (P-A) accessory motion at six lumbar levels (L-1 to sacral base) in 18 low back pain patients.
  • Mobility was rated on a nine-point scale, and pain reproduction was noted.
  • Intraclass correlation coefficients (ICCs) and Kappa analyses were used to determine agreement on spinal level identification, mobility findings, and treatment decisions.

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Main Results:

  • Interrater reliability for identifying the marked spinal level was moderate (ICC = .69).
  • Interrater reliability for assessing mobility findings at the marked level was poor (ICC = .25).
  • Agreement on treatment decision-making was also low.

Conclusions:

  • There is poor interrater reliability in posterior-anterior (P-A) accessory mobility testing of the lumbar spine.
  • Clinical decisions based solely on P-A accessory motion testing without corroborating data should be made with caution.
  • Improved standardization or adjunctive clinical data may be necessary to enhance reliability.