Inter- and intra-observer reliability of clinical movement-control tests for marines

BMC Musculoskeletal Disorders

Björn O Äng³  Kjell Norman⁴  Joachim Heuer¹  Andreas Monnier² 

[1] Fysiocenter Odenplan, Stockholm, Sweden;Swedish Armed Forces, Regional Medical Service Mälardalen, Berga, Sweden;Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden;Swedish Armed Forces, 1st Marine Regiment, 2nd Amphibious Battalion, Berga, Sweden

关键词: Validity;    Specificity;    Sensitivity;    Screening;    Reproducibility;    Motor control;    Military;   

Others  :  1134291
DOI  :  10.1186/1471-2474-13-263

 received in 2012-03-09, accepted in 2012-12-23,  发布年份 2012

【 摘 要 】

Background

Musculoskeletal disorders particularly in the back and lower extremities are common among marines. Here, movement-control tests are considered clinically useful for screening and follow-up evaluation. However, few studies have addressed the reliability of clinical tests, and no such published data exists for marines. The present aim was therefore to determine the inter- and intra-observer reliability of clinically convenient tests emphasizing movement control of the back and hip among marines. A secondary aim was to investigate the sensitivity and specificity of these clinical tests for discriminating musculoskeletal pain disorders in this group of military personnel.

Methods

This inter- and intra-observer reliability study used a test-retest approach with six standardized clinical tests focusing on movement control for back and hip. Thirty-three marines (age 28.7 yrs, SD 5.9) on active duty volunteered and were recruited. They followed an in-vivo observation test procedure that covered both low- and high-load (threshold) tasks relevant for marines on operational duty. Two independent observers simultaneously rated performance as “correct” or “incorrect” following a standardized assessment protocol. Re-testing followed 7–10 days thereafter. Reliability was analysed using kappa (κ) coefficients, while discriminative power of the best-fitting tests for back- and lower-extremity pain was assessed using a multiple-variable regression model.

Results

Inter-observer reliability for the six tests was moderate to almost perfect with κ-coefficients ranging between 0.56-0.95. Three tests reached almost perfect inter-observer reliability with mean κ-coefficients > 0.81. However, intra-observer reliability was fair-to-moderate with mean κ-coefficients between 0.22-0.58. Three tests achieved moderate intra-observer reliability with κ-coefficients > 0.41. Combinations of one low- and one high-threshold test best discriminated prior back pain, but results were inconsistent for lower-extremity pain.

Conclusions

Our results suggest that clinical tests of movement control of back and hip are reliable for use in screening protocols using several observers with marines. However, test-retest reproducibility was less accurate, which should be considered in follow-up evaluations. The results also indicate that combinations of low- and high-threshold tests have discriminative validity for prior back pain, but were inconclusive for lower-extremity pain.

【 授权许可】

   
2012 Monnier et al.; licensee BioMed Central Ltd.

【 图 表 】

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