The inter-examiner reliability of a classification method for non-specific chronic low back pain patients with motor control impairment.
The importance of classifying chronic low back pain (LBP) patients into homogeneous sub-groups has recently been emphasized. This paper reports on two studies examining clinicians ability to agree independently on patients' chronic LBP classification, using a novel classification system (CS) proposed by O'Sullivan. In the first study, a sub-group of 35 patients with non-specific chronic LBP were independently classified by two 'expert' clinicians. Almost perfect agreement (kappa-coefficient 0.96; %-of-agreement 97%) was demonstrated. In the second study, 13 clinicians from Australia and Norway were given 25 cases (patients' subjective information and videotaped functional tests) to classify. Kappa-coefficients (mean 0.61, range 0.47-0.80) and %-of-agreement (mean 70%, range 60-84%) indicated substantial reliability. Increased familiarity with the CS improved reliability. These studies demonstrate the reliability of this multi-dimensional mechanism-based CS and provide essential evidence in a multi-step validation process. A fully validated CS will have significant research and clinical application.
Dankaerts
W
W
School of Physiotherapy, Curtin University, Bentley 6102, WA, Australia. W.Dankaerts@exchange.curtin.edu.au
O'Sullivan
P B
PB
Straker
L M
LM
Burnett
A F
AF
Skouen
J S
JS
D000328:Adult; D001315:Australia; D002983:Clinical Competence; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000145:classification* / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged; D009043:Motor Activity; D009069:Movement Disorders / Q000145:classification* / Q000175:diagnosis*; D026201:Musculoskeletal Manipulations / Q000379:methods / Q000458:organization & administration; D009664:Norway; D015588:Observer Variation; D017063:Outcome Assessment, Health Care / Q000379:methods; D010808:Physical Examination / Q000379:methods*; D026741:Physical Therapy Modalities; D011237:Predictive Value of Tests; D015203:Reproducibility of Results