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 .
Interexaminer reliability of eight evaluative dimensions of lumbar segmental abnormality.
The interexaminer reliability of noninvasive methods of examining lumbar spinal segments is not well established . In this project the interexaminer reliability of three experienced chiropractic examiners , who evaluated 21 symptomatic and 25 asymptomatic subjects , was explored . Eight noninvasive segmental examination strategies ( dimensions ) were employed at each spinal segment from T11/T12 through L5/S1 . Marginal to good agreement beyond chance was noted for palpatory pain over osseous structures and in paraspinal soft-tissues . Weaker and less frequently , significant concordance between examiners was noted for detection of temperature differences ( greater than or equal to 1.5 degrees F ) between adjacent segments and for visual inspection for segmental abnormality . Little significant agreement between examiner was found for active and passive motion palpation , muscle tension palpation and misalignment palpation . This study suggests that " subjective " findings ( pain ) may be among the most reliable of conservative spinal observations . Weak but significant correlations were found when positive findings for the eight dimensions at each lumbar segment were summed to form a composite joint abnormality index . When the multidimension index was developed using the four most reliable dimensions , slightly stronger correlations were found . The strongest agreement between examiners tended to be found in the lower lumbar spine
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 .