Objectives: This study investigated the inter-rater reliability of three structural end-range lumbar segmental instability tests with the highest positive Likelihood Ratio against flexion-extension radiographs, and three functional mid-range clinical tests that predict the success of lumbar stabilization exercises in patients with recurrent or chronic low back pain (R/CLBP). It also investigated the reliability of lumbar segmental instability subclassification as: Functional, Structural and Combined Instability. Method: 40 adult with R/CLBP patients (30 men and 10 women), 18 to 80 years of age, underwent repeated measurements of specific clinical tests for structural or functional lumbar segmental instability. Results: Other than the Lack of Hypomobility with PA Glide test, which was found to be unreliable (percentage agreement = 37.5, and k= - 0.02), all the other tests demonstrated high Kappa coefficients and percentage agreements. The sub-classification categories of lumbar segmental instability (functional, structural, and combined) were found to be significantly reliable (k= 0.722, adjusted k= .7 and k =0.84, respectively). Discussion: All the investigated tests (except lack of hypomobility with PA glide test); as well as, the categories of lumbar segmental instability sub-classification, were significantly reliable in predicting lumbar stabilization. Key words: Low back pain, Segmental instability, Reliability, Physical examination, Clinical prediction rule. Discussion:
School of Allied Health Professions
Lohman III, Everett B.
Swen, R. Wesley
Doctor of Science (DSc)
Year Degree Awarded
Date (Title Page)
Library of Congress/MESH Subject Headings
Joint instability; Low Back Pain - diagnosis; Backache; Lumbar vertebrae;
Subject - Local
Low back pain; Segmental instability; Reliability; Physical examination; Clinical prediction rule; Lumbar
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Alyazedi, Faisal Mohammad, "Inter-rater Reliability of Lumbar Segmental Instability Tests and the Subclassification" (2013). Loma Linda University Electronic Theses, Dissertations & Projects. 112.
Loma Linda University Electronic Theses & Dissertations
Loma Linda University. Del E. Webb Memorial Library. University Archives