title: Interrater reliability of judgments of the centralization phenomenon and status change during movement testing in patients with low back pain.
abstract: OBJECTIVE
  To determine the interrater reliability of judgments of status change, including the centralization phenomenon during examination of the lumbar spine, and to determine the effects of training and experience on reliability.
  
  
  METHODS
  A videotape study of judgments by physical therapists and physical therapy students of the results of movement testing during the examination of patients with low back pain.
  
  
  METHODS
  Outpatient physical therapy clinic.
  
  
  METHODS
  Patients receiving physical therapy treatment for low back pain.
  
  
  METHODS
  Patients with low back pain were videotaped while performing a variety of movement tests including single, repeated, and sustained movements. Forty licensed physical therapists and 40 physical therapy students were provided with operational definitions of the three potential judgments of status change with movement testing; centralization, peripheralization, status quo. All therapists and students viewed the videotape and made a judgment regarding the patient's status change in response to the test.
  
  
  METHODS
  Percentage agreement and kappa coefficient values for agreement.
  
  
  RESULTS
  Interrater reliability was excellent for the total sample of examiners (kappa = .793), for the licensed physical therapists (kappa = .823), and for the students (kappa = .763).
  
  
  CONCLUSIONS
  Judgments of status change are reliable when operational definitions are provided. Clinical experience does not appear to substantially improve reliability.
authors.affiliation: Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, PA, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Fritz
authors.forename: A
authors.initials: A
authors.lastname: Delitto
authors.forename: M
authors.initials: M
authors.lastname: Vignovic
authors.forename: R G
authors.initials: RG
authors.lastname: Busse
mesh_terms: D000328:Adult; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D009068:Movement; D026741:Physical Therapy Modalities / Q000193:education / Q000379:methods*; D015203:Reproducibility of Results; D013334:Students; D014743:Videotape Recording