Inter- and intra-rater reliability of clinical tests associated to functional lumbar segmental instability and motor control impairment in patients with LBP: a systematic review

Publication date: Available online 26 August 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Lenie Denteneer, Gaetane Stassijns, Willem De Hertogh, Steven Truijen, Ulrike Van Daele
ObjectiveTo provide a comprehensive overview of clinical tests associated with functional lumbar segmental instability and motor control impairment in patients with low back pain (LBP) and to investigate their intra and/or inter-rater reliability.Data sourcesA systematic computerized search was conducted in four different databases on the 1^st of December 2015: Pubmed (1972 - ) , Web of Science (1955 - ), Embase (1947 - ), Medline ( 1946 - ).Study selectionPRISMA guidelines were followed during design, search and reporting stages of this review. The included population are patients with primary LBP. Data was extracted as follows: (1) description and scoring of the clinical tests (2) population characteristics (3) in- and exclusion criteria (4) description of the used procedures (5) results for both intra- and inter-rater reliability and eventually (6) notification on used statistical method. The risk of bias (ROB) of the included articles was assessed with the use of the COSMIN checklist.Data synthesisA total of 16 records were eligible and 30 clinical tests were identified. All included studies investigated inter-rater reliability and three studies investigated intra-rater reliability. The identified Inter-rater reliability scores ranged from poor to very good (k-0.09-0.89 and ICC 0.72-0.96) and the Intra-rater reliability scores ranged from fair to very good (k 0.51-0.86).ConclusionsThree clinical tests (aberrant Movement pattern, prone instability test and the beighton scale) could be identified for having an adequate inter-rater reliability. No conclusions could be made for intra-rater reliability. However, further research should focus on better study designs, provide an overall agreement for uniformity and interpretation of clinical tests and should implement research regarding validity.



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