Abstract
Objectives
To provide a comprehensive overview of clinical tests associated with functional lumbar
segmental instability and motor control impairment in patients with low back pain
(LBP), and to investigate their intrarater reliability, interrater reliability, or
both.
Data Sources
A systematic computerized search was conducted on December 1, 2015, in 4 different
databases (starting search year is indicated in parentheses, with articles included
from that year until December 1, 2015): PubMed (1972–), Web of Science (1955–), Embase
(1947–), and MEDLINE (1946–).
Study Selection
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were
followed during design, search, and reporting stages of this review. The included
population comprised patients with primary LBP.
Data Extraction
Data were extracted as follows: (1) description and scoring of the clinical tests;
(2) population characteristics; (3) inclusion and exclusion criteria; (4) description
of the used procedures; (5) results for both intra- and interrater reliability; and
eventually (6) notification on used statistical method. The risk of bias of the included
articles was assessed with the use of the COnsensus-based Standards for the selection
of health Measurement INstruments checklist.
Data Synthesis
A total of 16 records were eligible, and 30 clinical tests were identified. All included
studies investigated interrater reliability, and 3 studies investigated intrarater
reliability. The identified interrater reliability scores ranged from poor to very
good (κ=−.09 to .89; intraclass correlation coefficient, .72–.96), and the intrarater
reliability scores ranged from fair to very good (κ=.51–.86).
Conclusions
Three clinical tests (aberrant movement pattern, prone instability test, Beighton
Scale) could be identified as having an adequate interrater reliability. No conclusions
could be made for intrarater reliability. However, further research should focus on
better study designs, provide an overall agreement for uniformity and interpretation
of clinical tests, and should implement research regarding validity.
Keywords
List of abbreviations:
COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments), GRADE (Grading of Recommendations Assessment, Development and Evaluation), ICC (intraclass correlation coefficient), LBP (low back pain), LSI (lumbar segmental instability), MCI (motor control impairment), ROB (risk of bias)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 25, 2016
Footnotes
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
