title: The inter-tester reliability of physical therapists classifying low back pain problems based on the movement system impairment classification system.
abstract: OBJECTIVE
  The classification of patients with low back pain (LBP) may be important for improving clinical outcomes and research efficiency. The purpose of this study was to examine the inter-tester reliability of 2 trained physical therapists to classify patients with LBP by using the standardized Movement System Impairment (MSI) classification system. The 5 proposed MSI classifications are based on the most consistent patterns of movement and alignment observed throughout the examination that correlate with the patient's symptom behavior.
  
  
  METHODS
  Test-retest to assess reliability
  
  
  METHODS
  Academic healthcare center outpatient facility
  
  
  METHODS
  Thirty subjects (21 women and 9 men) with chronic, recurrent LBP (mean age 31.1 +/- 12.9 years) were examined independently by 2 experienced physical therapists.
  
  
  METHODS
  Training consisted of self-study of a procedure manual, a supervised practice of examination procedures and classification rules, and discussion. Subjects were examined independently by each therapist using a test-retest design. Each therapist assigned a LBP classification upon completion of the examination. Both therapists were blinded to the other therapist's findings.
  
  
  METHODS
  Inter-tester reliability of therapists classifying the LBP problems was indexed by the percent agreement and kappa coefficient.
  
  
  RESULTS
  Overall percent agreement on the classification assigned was 83% with kappa = 0.75 (95% confidence interval = 0.51-0.99; P < .0001).
  
  
  CONCLUSIONS
  Inter-tester reliability of classification of patients with LBP when therapists use a standardized clinical examination based on the MSI classification system is substantial.
authors.affiliation: Washington University School of Medicine, St. Louis, MO 63108, USA. harrisma@wustl.edu
authors.forename: Marcie
authors.initials: M
authors.lastname: Harris-Hayes
authors.forename: Linda R
authors.initials: LR
authors.lastname: Van Dillen
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000145:classification* / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D015588:Observer Variation; D010147:Pain Measurement; D026761:Physical Therapy Specialty / Q000193:education*; D016059:Range of Motion, Articular / Q000502:physiology*; D015203:Reproducibility of Results; D055815:Young Adult