Based on the upper threshold used ( kappa/ICC > 0.85 ) most procedures demonstrated either conflicting evidence or moderate to strong evidence of low reliability .
When the lower threshold was used ( kappa/ICC > 0.70 ) evidence about pain response to repeated movements changed from contradictory to moderate evidence for high reliability .
Most procedures commonly used by clinicians in the examination of patients with back pain demonstrate low reliability
The purpose of this systematic review was to determine the quality of the research and to assess the reliability of different types of physical examination procedures used in the assessment of patients with non-specific low back pain .
Intertester reliability of a low back pain classification system.
STUDY DESIGN This prospect i ve study of intertester reliability examined pairs of therapists ' ability to agree independently on a patient 's low back pain diagnosis . OBJECTIVE To determine the intertester reliability of a low back pain classification system among experienced and novice clinicians . BACKGROUND Many of the disparate categorization schemes for patients with low back pain are purely nominal , assigning design ations based on the presumptive source of the problem without providing any practical guide for rehabilitation . A useful classification scheme reliably groups patients into treatment-directing categories . METHODS The study included 204 patients with low back pain referred to 10 clinics across Canada . Paired physiotherapists performed separate physical examinations on each patient . Both examiners then completed a simple ballot choosing one of five pain patterns . RESULTS Agreement on patient classification by independent examiners was 78.9 % ( kappa = 0.61 ) . CONCLUSION This clinical ly relevant and clearly defined pain pattern system uses key elements of the history and examination to classify patients with low back pain . The pattern provides a framework for initiating active rehabilitation strategy . Using this approach , clinicians agreed on the categorization of 78.9 % of mechanical low back pain cases
Based on the upper threshold used ( kappa/ICC > 0.85 ) most procedures demonstrated either conflicting evidence or moderate to strong evidence of low reliability .
When the lower threshold was used ( kappa/ICC > 0.70 ) evidence about pain response to repeated movements changed from contradictory to moderate evidence for high reliability .
Most procedures commonly used by clinicians in the examination of patients with back pain demonstrate low reliability
The purpose of this systematic review was to determine the quality of the research and to assess the reliability of different types of physical examination procedures used in the assessment of patients with non-specific low back pain .