Reliability of detection of lumbar lateral shift.
OBJECTIVE
The poor reliability of lateral shift detection has been attributed to lack of rater training, biologic variation, and test reactivity. This study aimed to remove the potential confounding arising from biological variation and test reactivity and control the level of rater experience/training in making judgments of lateral shift.


METHODS
One hundred forty-eight raters with 3 levels of clinical physical therapy experience and training in the McKenzie method participated.


METHODS
The raters viewed photographic slides of 45 patients with low back pain. Slides were judged on a numerical scale for presence and direction of a shift. Intrarater reliability was evaluated using the intraclass correlation coefficient (ICC) and interrater reliability was evaluated using both the ICC and kappa statistic.


RESULTS
Reliability of shift judgments was only moderate for all groups (eg, ICC [2,1] values ranged from 0.48 to 0.64).


CONCLUSIONS
Lateral shift judgements have only moderate reliability, even when trained raters judge stable stimuli. We propose that the photo model employed can be used to explore the source of error in this process.
School of Physiotherapy, The University of Sydney, Australia. clare@magna.com.au
Helen A
HA
Clare
Roger
R
Adams
Christopher G
CG
Maher
D000328:Adult; D001315:Australia; D002684:Chiropractic / Q000193:education / Q000592:standards; D002983:Clinical Competence / Q000592:standards; D003937:Diagnosis, Differential; D004503:Education, Medical, Graduate / Q000592:standards; D004504:Education, Medical, Undergraduate / Q000592:standards; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011859:Radiography; D015203:Reproducibility of Results; D013997:Time Factors