The inter-examiner reliability of a classification method for non-specific chronic low back pain patients with motor control impairment

Man Ther. 2006 Feb;11(1):28-39. doi: 10.1016/j.math.2005.02.001. Epub 2005 Jun 3.

Abstract

The importance of classifying chronic low back pain (LBP) patients into homogeneous sub-groups has recently been emphasized. This paper reports on two studies examining clinicians ability to agree independently on patients' chronic LBP classification, using a novel classification system (CS) proposed by O'Sullivan. In the first study, a sub-group of 35 patients with non-specific chronic LBP were independently classified by two 'expert' clinicians. Almost perfect agreement (kappa-coefficient 0.96; %-of-agreement 97%) was demonstrated. In the second study, 13 clinicians from Australia and Norway were given 25 cases (patients' subjective information and videotaped functional tests) to classify. Kappa-coefficients (mean 0.61, range 0.47-0.80) and %-of-agreement (mean 70%, range 60-84%) indicated substantial reliability. Increased familiarity with the CS improved reliability. These studies demonstrate the reliability of this multi-dimensional mechanism-based CS and provide essential evidence in a multi-step validation process. A fully validated CS will have significant research and clinical application.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Australia
  • Clinical Competence
  • Female
  • Humans
  • Low Back Pain / classification*
  • Low Back Pain / diagnosis*
  • Low Back Pain / therapy
  • Middle Aged
  • Motor Activity
  • Movement Disorders / classification*
  • Movement Disorders / diagnosis*
  • Musculoskeletal Manipulations / methods
  • Musculoskeletal Manipulations / organization & administration
  • Norway
  • Observer Variation
  • Outcome Assessment, Health Care / methods
  • Physical Examination / methods*
  • Physical Therapy Modalities
  • Predictive Value of Tests
  • Reproducibility of Results