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The Inter‐Tester Reliability of Physical Therapists Classifying Low Back Pain Problems Based on the Movement System Impairment Classification System
Author(s) -
HarrisHayes Marcie,
Van Dillen Linda R.
Publication year - 2009
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2008.08.001
Subject(s) - medicine , reliability (semiconductor) , physical therapy , cohen's kappa , kappa , physical therapist , test (biology) , low back pain , confidence interval , functional movement , physical examination , physical medicine and rehabilitation , machine learning , alternative medicine , surgery , paleontology , power (physics) , linguistics , physics , philosophy , pathology , quantum mechanics , computer science , biology
Objective The classification of patients with low back pain (LBP) may be important for improving clinical outcomes and research efficiency. The purpose of this study was to examine the inter‐tester reliability of 2 trained physical therapists to classify patients with LBP by using the standardized Movement System Impairment (MSI) classification system. The 5 proposed MSI classifications are based on the most consistent patterns of movement and alignment observed throughout the examination that correlate with the patient's symptom behavior. Design Test‐retest to assess reliability Setting Academic healthcare center outpatient facility Participants Thirty subjects (21 women and 9 men) with chronic, recurrent LBP (mean age 31.1 ± 12.9 years) were examined independently by 2 experienced physical therapists. Methods Training consisted of self‐study of a procedure manual, a supervised practice of examination procedures and classification rules, and discussion. Subjects were examined independently by each therapist using a test‐retest design. Each therapist assigned a LBP classification upon completion of the examination. Both therapists were blinded to the other therapist's findings. Main Outcome Measures Inter‐tester reliability of therapists classifying the LBP problems was indexed by the percent agreement and kappa coefficient. Results Overall percent agreement on the classification assigned was 83% with kappa = 0.75 (95% confidence interval = 0.51‐0.99; P < .0001). Conclusion Inter‐tester reliability of classification of patients with LBP when therapists use a standardized clinical examination based on the MSI classification system is substantial.