The inter-rater reliability of clinical observation of prone hip extension and association between aberrant movement and chronic low back pain

Abstract

BackgroundClinical observation of aberrant movement patterns during prone hip extension (PHE) is commonly used in clinical practice to identify patients with low back pain. It could be clinically useful to identify individuals with chronic low back pain during remission (CLBPremission) to provide proactive intervention to prevent exacerbation of low back symptoms. ObjectivesThis study aimed to establish inter-rater reliability of clinical observation of PHE and association between aberrant movement pattern and CLBPremission. DesignA cross-sectional study. MethodTwenty-six participants with CLBPremission and 18 participants without history of low back pain (NoLBP) performed 3 repetitions of active PHE, while 2 examiners concurrently observed and independently rated the movements as “presence” or “absence” of aberrant movement. Kappa statistics were used to establish inter-rater reliability based on rating data from 2 examiners, while chi-square tests were used to determine the association between aberrant movement and CLBPremission based on ratings (presence and absence) and known groups (CLBPremission and NoLBP). ResultsKappa values ranged from fair to moderate (Kappa = 0.36–0.58). Result also demonstrated a significant association (P < 0.05) between presence of aberrant movement and CLBPremission. Findings indicate fair to moderate inter-rater reliability which are sufficient for clinical practice. The findings also indicated presence of aberrant movement patterns during active PHE was associated with CLBPremission. ConclusionsThese findings suggested the usefulness of clinical observation of aberrant movement pattern during PHE to identify CLBPremission. The detection of aberrant movement would help clinicians to provide preventive program to minimize the risk of recurrent episodes of low back symptoms.