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 .
Intra- and interobserver reliability of passive motion palpation of the lumbar spine.
Sixty student volunteers were assessed for fixation in the lumbar spine using a passive motion palpation protocol . Subjects were examined in r and om order by two experienced chiropractors . Every subject was evaluated twice by each examiner . Fixations were judged present or absent for each of five lumbar motion segments . Moderate test-retest agreement beyond chance was noted at L1/2 , minimal reliability at L4/5 , and no significant agreement within examiners was detected for mid-lumbar segments . Interexaminer agreement beyond chance was poor for all segments assessed . When segments were grouped regionally and re-evaluated , some increase in intrarater agreement was evident , especially at L4/5/S , but interrater agreement was still absent
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 .