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Table 3 Intra-rater reliability of commonly used clinical tests of the spine (binary variables)

From: Screening of the spine in adolescents: inter- and intra-rater reliability and measurement error of commonly used clinical tests

Test (missing values)

Prevalence of positive findings

Agreement

Reliability

 

Rater 1 (N = 39)

Rater 2 (N = 36)

Rater 1

Rater 2

Rater 1

Rater 2

 

Ex 1% (n)

Ex 2% (n)

Ex 1% (n)

Ex 2% (n)

Pa(%)

Pa(%)

Kappa (95% CI)

Kappa (95% CI)

Scoliosis

        

  Shoulder height

28.2 (11)

18.0 (7)

36.1 (13)

30.6 (11)

84.6

69.4

0.59 (0.36, 0.85)

0.39 (0.37, 0.58)

  Adam’s forward bend test (1)

12.8 (5)

18.0 (7)

11.4 (4)

5.6 (2)

84.6

94.3

0.41 (0.03, 0.80)

0.64 (0.19, 1.00)*

Hypermobility

        

  Knee

R

0.0 (0)

2.6 (1)

8.3 (3)

5.6 (2)

97.4

97.2

-

0.79 (0.38, 1.00)*

 

L

0.0 (0)

2.6 (1)

5.6 (2)

2.8 (1)

97.4

97.2

-

0.65 (0.03, 1.00)*

  Elbow

R

15.4 (6)

23.1 (9)

19.4 (7)

16.7 (6)

92.3

86.1

0.76 (0.50, 1.00)

0.53 (0.17, 0.89)

 

L

25.6 (10)

30.8 (12)

22.2 (8)

27.8 (10)

94.9

94.4

0.87 (0.71, 1.00)

0.85 (0.66, 1.00)

  Thumb

R

10.3 (4)

10.3 (4)

13.9 (5)

13.9 (5)

100.0

94.4

1.00 (1.00, 1.00)*

0.77 (0.46, 1.00)

 

L

12.8 (5)

10.3 (4)

8.3 (3)

11.1 (4)

92.3

97.2

0.62 (0.24, 1.00)*

0.84 (0.54, 1.00)*

  Fifth finger

R

0.0 (0)

0.0 (0)

2.8 (1)

0.0 (0)

-

-

-

-

 

L

2.6 (1)

0.0 (0)

2.8 (1)

2.8 (1)

-

97.2

-

1.00 (1.00, 1.00)*

Trunk flexion (4)

0.0 (0)

0.0 (0)

2.9 (1)

2.9 (1)

97.4

100.0

-

1.00 (1.00, 1.00)*

Beighton score ≥ 4

2.6 (1)

5.1 (2)

5.6 (2)

5.6 (2)

97.4

100.0

0.66 (0.03, 1.00)*

1.00 (1.00, 1.00)*

Beighton score ≥ 5

0.0 (0)

2.6 (1)

5.6 (2)

5.6 (2)

97.4

100.0

-

1.00 (1.00, 1.00)*

Intersegmental mobility

        

  Restriction

Cx

74.4 (29)

76.9 (30)

86.1 (31)

91.7 (33)

92.3

88.9

0.79 (0.57, 1.00)

0.44 (-0.01,- 0.89)

 

Tx

15.4 (6)

18.0 (7)

58.3 (21)

50.0 (18)

92.3

69.4

0.72 (0.43, 1.00)

0.39 (0.09, 0.69)

 

Lx

38.5 (15)

56.4 (22)

47.2 (17)

41.7 (15)

71.8

77.8

0.45 (0.19, 0.71)

0.55 (0.28, 0.82)

 

SI

2.6 (1)

2.6 (1)

22.2 (8)

11.1 (4)

94.9

83.3

-0.03 (-0.09, 0.04)*

0.41 (0.04, 0.78)*

  Pain response

Cx

35.9 (14)

33.3 (13)

44.4 (16)

38.9 (14)

87.2

88.9

0.72 (0.49, 0.95)

0.77 (0.56, 0.98)

 

Tx

12.8 (5)

18.0 (7)

33.3 (12)

38.9 (14)

94.9

83.3

0.80 (0.55, 1.00)

0.64 (0.38, 0.90)

 

Lx

25.6 (10)

33.3 (13)

27.8 (10)

38.9 (14)

92.3

88.9

0.82 (0.62, 1.00)

0.75 (0.53, 0.97)

 

SI

5.1 (2)

2.6 (1)

8.3 (3)

8.3 (3)

92.3

94.4

-0.04 (-0.11, 0.04)*

0.64 (0.17, 1.00)*

End range pain

        

  Lumbar

R lat flex (2)

5.1 (2)

5.1 (2)

2.9 (1)

8.6 (3)

100.0

91.2

1.00 (1.00, 1.00)*

0.00 ( - , 1.00)*

 

L lat flex (2)

12.8 (5)

5.1 (2)

2.9 (1)

8.6 (3)

92.3

88.2

0.54 (0.09, 0.98)*

-0.05 (-0.14, 0.05)*

 

Flex

18.0 (7)

12.8 (5)

2.8 (1)

5.6 (2)

79.5

91.7

0.22 (-0.16, 0.60)

-0.04 (-0.12, 0.04)*

 

Ext (4)

23.7 (9)

23.7 (9)

34.3 (12)

25.7 (9)

94.6

82.4

0.85 (0.66, 1.00)

0.58 (0.28, 0.88)

  Cervical

R Rot (1)

0.0 (0)

0.0 (0)

5.6 (2)

2.8 (1)

-

94.4

-

0.00 ( - , 1.00)*

 

L Rot (1)

0.0 (0)

0.0 (0)

5.6 (2)

0.0 (0)

-

91.7

-

-0.04 (-0.12, 0.04)*

 

Flex (1)

5.3 (2)

5.1 (2)

5.6 (2)

2.8 (1)

100.0

97.2

1.00 (1.00, 1.00)*

0.65 (0.03, 1.00)*

 

Ext (1)

2.6 (1)

5.1 (2)

5.6 (2)

5.6 (2)

97.4

94.4

0.66 (0.03, 1.00)*

0.47 (-0.15, 1.00)*

  1. Ex = examination; P a  = percentage of agreement; Cx = cervical spine; Tx = thoracic spine; Lx = lumbar spine; SI = sacroiliac joints; R = right; L = left; ROM = Range of motion.
  2. *The cell size of positive findings is ≤5, so the Kappa values should be interpreted with caution. Clinically acceptable Kappa values in bold.