Inter- and Intra-observer Agreement of the Motion Palpation Test for Lumbar Vertebral Rotational Asymmetry.
OBJECTIVE
To investigate inter- and intra-observer agreement in the assessment of lumbar vertebral rotational (VR) asymmetry by a motion palpation test.


METHODS
For this prospective and descriptive test-retest study, 51 asymptomatic participants (40 women, 11 men; mean age 23.3 [SD 5.6] years) were recruited from the community. Each participant was assessed in two sessions by the same three observers, who assessed VR by means of a palpatory test for movement asymmetry. This test is performed by applying posteroanterior pressure in an alternating manner to the left and right transverse processes of a vertebra to determine motion asymmetry in the transverse plane and thus the vertebral position. Observers classified the vertebral position as neutral, rotation to the right, and rotation to the left; they were blinded to which participant was being assessed and to any previous results.


RESULTS
Intra- and inter-observer agreement was verified by the kappa coefficient (κ) and the weighted kappa coefficient (κ w ). Values of κ and κ w varied from 0.07 (95% CI, -0.10 to 0.245) to 0.37 (95% CI, 0.11-0.63) for intra-observer agreement and from 0.12 (95% CI, -0.06 to 0.29) to 0.30 (95% CI, 0.08-0.52) for inter-observer agreement.


CONCLUSIONS
The motion palpation test used to assess VR asymmetry has low agreement levels; therefore, its clinical significance for measuring vertebral position is questionable.
Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil.
Marcelo Anderson
MA
Bracht
Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil.
Guilherme S
GS
Nunes
Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil.
Jardel
J
Celestino
Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil.
Debora Soccal
DS
Schwertner
Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil.
Leandro Cardoso
LC
França
Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil ; Department of Allied Health, La Trobe University, Bendigo, VIC, Australia.
Marcos
M
de Noronha
lumbar vertebrae; motion palpation test; reproducibility of results; spine