Education of physiotherapists improves inter-rater reliability in lumbar spine motor control tests: A randomized controlled trial

Abstract

Objectives: To determine the effect of 1-h education session, compared with no education, on physiotherapists' (PTs) inter-rater reliability in two lumbar spine motor control tests (MCTs): waiter's bow (WB) and sitting knee extension (SKE). To determine whether reliability at baseline and the effect of education are affected by PT's clinical experience, knowledge and experience of MCTs, and post-graduate education in manual therapy.

Design: Randomized controlled trial.

Participants: 54 PTs.

Intervention: The experimental group (EG) took part in a 1-h group education session. Control group (CG) had no intervention.

Measurements: At baseline and after EG had completed the education session, therapists rated 40 SKE and 40 WB video recordings.

Analysis: Changes in Fleiss' kappa were compared between groups. Differences >0.1 in kappa values were considered meaningful. Regression analysis was used to evaluate the effect of therapist's characteristics on inter-rater reliability at baseline and changes in inter-rater reliability.

Results: Education had significant and meaningful effect on reliability compared with no education. WB kappa values improved from 0.36 to 0.63 in the experimental group and from .39 to .46 in the control group. SKE kappa values improved from .50 to .71 in the EG and from 0.49 to 0.57 in the CG. None of PTs' characteristics affected reliability at baseline or education effects.

Conclusion: The effect of 1-h group education session for physiotherapists on inter-rater reliability in MCTs is significant and meaningful. Provision of education for PTs in performing observational tests would improve inter-rater reliability, resulting in improved treatment planning and outcome evaluation.

Keywords: Education; Low back pain; Motor control test; Observational test; Randomized controlled trial; Reliability.