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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.