Interrater Reliability of Performing a Step-by-Step Procedure for Selected Pain Provocation Tests for Hamstrings and Special Tests for Other Lower Extremity Musculoskeletal Injuries


Objective: Our study aims to establish interrater reliability in performing the step-by-step procedure of selected pain provocation tests for hamstrings and special tests for lower extremity musculoskeletal injuries.

Study Design : An interrater reliability study

Setting: University of Santo Tomas - Sports Science Laboratory

Participants: Ten healthy adults (five females, five males; age = 22.2 ± 0.42) from the university community.

Main Outcome Measures: Interrater reliability of performing step-by-step procedures for selected pain provocation tests for hamstrings (painful resisted knee flexion 90°, painful resisted knee flexion 30°, active slump test, Puranen-Orava Test, bent knee stretch) and special tests for lower extremity musculoskeletal injuries (Lachman’s test, McMurray’s test, posterior drawer test, valgus, and varus stress test).

Results: Fleiss kappa showed perfect agreement (κ = 1.00) for all test procedures except for Lachman’s test procedure 1 (κ= -0.11 [95% CI, -0.36 to 0.14]), active slump test procedure 4 (κ= -0.03 [95% CI, -0.28 to 0.23]), active slump test procedure 5 (κ= -0.11 [95% CI, -0.28 to 0.23]), and active slump test procedure 6 (κ= -0.05 [95% CI, -0.31 to 0.20]), which resulted in negative agreements.

Conclusions: The researcher developed protocols for each special and provocative test were consistent in measuring the intended procedures, and the raters were generally consistent with their ability to measure these tests.

Keywords: Interrater reliability, special tests, pain provocation tests, lower extremity injuries

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