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 the McKenzie evaluation in assessing patients with mechanical low-back pain.
STUDY DESIGN Prospect i ve intertester reliability study investigating the ability of 2 therapists to agree on a low back pain diagnosis using examination techniques and the classification system described by McKenzie . OBJECTIVES To investigate intertester agreement in determining McKenzie diagnostic syndromes , subsyndromes , presence , and relevance of the spinal deformities . BACKGROUND Reliability of the McKenzie approach for determining diagnostic categories is unclear . Previous studies have been characterized by inconsistency of test protocol s , criterion measures , and level of training of the examiners , which confounds the interpretation of results . METHODS Patients were assessed simultaneously by 2 physical therapists trained in the McKenzie evaluation system .  The therapists were r and omly assigned as examiner and observer . Agreement was estimated by Kappa statistics . RESULTS Forty-five subjects ( 47 + /- 14 years ) , composed of 25 women and 20 men with acute , subacute , or chronic low back pain were examined . The agreement between raters for selection of the McKenzie syndromes was kappa = 0.70 , and for the derangement subsyndromes was kappa = 0.96 . Interrater agreement for presence of lateral shift , relevance of lateral shift , relevance of lateral component , and deformity in sagittal plane was kappa = 0.52 , 0.85 , 0.95 , and 1.00 , respectively . Intertester agreement on syndrome categories in 17 patients under 55 years of age was excellent , with kapp = 1.00 . CONCLUSIONS A form of low back evaluation , using patterns of pain response to repeated end range spinal test movements , was highly reliable when performed by 2 properly trained physical therapists
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 .