Original Article
Interrater Reliability of a Passive Physiological Intervertebral Motion Test in the Mid-Thoracic Spine

https://doi.org/10.1016/j.jmpt.2006.04.009Get rights and content

Abstract

Objective

To examine the interrater reliability of a passive physiological intervertebral motion (PPIM) test of a mid-thoracic spine motion segment.

Methods

Nineteen males and 22 females with a mean age of 22.7 years (range, 19-40 years) and no known spinal pathologies were tested independently by 3 certified manual therapy instructors. Investigators performed 3-dimensional segmental mobility testing at a preselected thoracic motion segment. Interrater reliability was assessed with Cohen's κ statistics, using 3 pairwise comparisons for determination of the direction of lateral flexion leading to the greatest amount of segmental rotation.

Results

Percent agreement ranges were 63.4% to 82.5%, with κ scores ranging from 0.27 to 0.65.

Conclusion

The PPIM testing demonstrated fair to substantial interrater reliability. A majority of females (91%) demonstrated greatest segmental PPIM motion in contralateral rotation with lateral flexion, whereas a majority of males (90%) demonstrated greatest segmental PPIM motion in ipsilateral rotation with lateral flexion. These findings are applicable to asymptomatic subjects of the same age category. Interrater reliability of 3-dimensional PPIM testing is fair to substantial for assessing passive segmental mobility of the mid-thoracic spine.

Section snippets

Subjects

Forty-three volunteer subjects were recruited from a population of college students using flyers and recruitment in class at the Department of Rehabilitation Sciences of Texas Tech University Health Sciences Center. Each subject provided written informed consent to participate and completed a demographic questionnaire. None of the subjects reported being pregnant and all denied previous or current vertebral motion-limiting conditions, such as back surgery, spinal fusion, scoliosis with a

Results

Forty-one subjects (19 male, 22 female), aged 19 to 40 years (mean, 22 years), participated in the study. The percent agreement for the 3-dimensional PPIM test ranged from 63.4% to 82.5%. The pairwise κ scores ranged from 0.27 to 0.65 and the overall κ score was 0.41. As a result, the 3-dimensional thoracic PPIM test showed fair to substantial interrater reliability as defined by Landis and Koch.29 Percent agreement and pairwise κ scores are summarized in Table 1. The Spearman rank correlation

Discussion

The present study results indicated fair to substantial interrater reliability of segmental PPIM testing of the thoracic spine. This is surprising as previous research of interrater reliability of thoracic and thoracolumbar segmental palpation reported poor (κ = −0.03)25 to fair (κ = 0.35)26 reliability values. Such differences in reliability outcome can be explained by the fact that the testing performed was different in previous studies vs the present study, as both Keating et al25 and Haas

Conclusion

The 3-dimensional thoracic PPIM test is a tool used by trained clinicians to manually investigate mid-thoracic segmental movement patterns. The outcome of this study indicates that this technique demonstrates fair to substantial interrater reliability, when performed on asymptomatic subjects. Further research is needed to determine the intrarater reliability and validity of the 3-dimensional PPIM motion test. In addition, reliability and validity should be investigated using clinicians with

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    This project was not supported by grant funding.

    Work is attributed to Texas Tech University Health Sciences Center, Department of Rehabilitation Sciences, and the International Academy of Orthopedic Medicine.

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