{"id":{"repo_id":"loma-linda","oai_identifier":"oai:scholarsrepository.llu.edu:etd-1111"},"canonical_url":"https://search.dev.ndltd.org/etd/loma-linda/oai:scholarsrepository.llu.edu:etd-1111","repository":{"repo_id":"loma-linda","name":"Loma Linda University","base_url":"https://scholarsrepository.llu.edu/do/oai/"},"display":{"title":"Inter-rater Reliability of Lumbar Segmental Instability Tests and the Subclassification","abstract":"Objectives: This study investigated the inter-rater reliability of three structural end-range lumbar segmental instability tests with the highest positive Likelihood Ratio against flexion-extension radiographs, and three functional mid-range clinical tests that predict the success of lumbar stabilization exercises in patients with recurrent or chronic low back pain (R/CLBP). It also investigated the reliability of lumbar segmental instability subclassification as: Functional, Structural and Combined Instability. Method: 40 adult with R/CLBP patients (30 men and 10 women), 18 to 80 years of age, underwent repeated measurements of specific clinical tests for structural or functional lumbar segmental instability. Results: Other than the Lack of Hypomobility with PA Glide test, which was found to be unreliable (percentage agreement = 37.5, and k= - 0.02), all the other tests demonstrated high Kappa coefficients and percentage agreements. The sub-classification categories of lumbar segmental instability (functional, structural, and combined) were found to be significantly reliable (k= 0.722, adjusted k= .7 and k =0.84, respectively). Discussion: All the investigated tests (except lack of hypomobility with PA glide test); as well as, the categories of lumbar segmental instability sub-classification, were significantly reliable in predicting lumbar stabilization. Key words: Low back pain, Segmental instability, Reliability, Physical examination, Clinical prediction rule. Discussion:","abstract_html":"Objectives: This study investigated the inter-rater reliability of three structural end-range lumbar segmental instability tests with the highest positive Likelihood Ratio against flexion-extension radiographs, and three functional mid-range clinical tests that predict the success of lumbar stabilization exercises in patients with recurrent or chronic low back pain (R/CLBP). It also investigated the reliability of lumbar segmental instability subclassification as: Functional, Structural and Combined Instability. Method: 40 adult with R/CLBP patients (30 men and 10 women), 18 to 80 years of age, underwent repeated measurements of specific clinical tests for structural or functional lumbar segmental instability. Results: Other than the Lack of Hypomobility with PA Glide test, which was found to be unreliable (percentage agreement = 37.5, and k= - 0.02), all the other tests demonstrated high Kappa coefficients and percentage agreements. The sub-classification categories of lumbar segmental instability (functional, structural, and combined) were found to be significantly reliable (k= 0.722, adjusted k= .7 and k =0.84, respectively). Discussion: All the investigated tests (except lack of hypomobility with PA glide test); as well as, the categories of lumbar segmental instability sub-classification, were significantly reliable in predicting lumbar stabilization. Key words: Low back pain, Segmental instability, Reliability, Physical examination, Clinical prediction rule. Discussion:","abstract_has_math":false,"creators":["Alyazedi, Faisal Mohammad"],"institution":null,"degree_name":"Doctor of Science (DSc)","degree_level":"Dissertation","degree_discipline":"Physical Therapy","degree_department":null,"school":null,"contributors":["Lohman III, Everett B.","Bahjri, Khaled","Swen, R. Wesley"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2013,"date_issued":"2013-12-01T08:00:00Z","date_published":"2013-12-01T08:00:00Z","updated_at":"2026-07-24T02:52:15Z","subjects":["Physical Therapy","Joint instability; Low Back Pain - diagnosis; Backache; Lumbar vertebrae;","Low back pain","Segmental instability","Reliability","Physical examination","Clinical prediction rule","Lumbar"],"languages":["English"],"rights":["This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights."],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://scholarsrepository.llu.edu/etd/112","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Lohman III, Everett B.","Bahjri, Khaled","Swen, R. 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The author retains all other copyrights."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://scholarsrepository.llu.edu/etd/112"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Objectives: This study investigated the inter-rater reliability of three structural end-range lumbar segmental instability tests with the highest positive Likelihood Ratio against flexion-extension radiographs, and three functional mid-range clinical tests that predict the success of lumbar stabilization exercises in patients with recurrent or chronic low back pain (R/CLBP). It also investigated the reliability of lumbar segmental instability subclassification as: Functional, Structural and Combined Instability. Method: 40 adult with R/CLBP patients (30 men and 10 women), 18 to 80 years of age, underwent repeated measurements of specific clinical tests for structural or functional lumbar segmental instability. Results: Other than the Lack of Hypomobility with PA Glide test, which was found to be unreliable (percentage agreement = 37.5, and k= - 0.02), all the other tests demonstrated high Kappa coefficients and percentage agreements. The sub-classification categories of lumbar segmental instability (functional, structural, and combined) were found to be significantly reliable (k= 0.722, adjusted k= .7 and k =0.84, respectively). Discussion: All the investigated tests (except lack of hypomobility with PA glide test); as well as, the categories of lumbar segmental instability sub-classification, were significantly reliable in predicting lumbar stabilization. Key words: Low back pain, Segmental instability, Reliability, Physical examination, Clinical prediction rule. Discussion:"]},{"key":"dc:title","label":"Title","values":["Inter-rater Reliability of Lumbar Segmental Instability Tests and the Subclassification"]}]}],"canonical_facts":{"dc:contributor":["Lohman III, Everett B.","Bahjri, Khaled","Swen, R. Wesley"],"dc:creator":["Alyazedi, Faisal Mohammad"],"dc:description.abstract":["Objectives: This study investigated the inter-rater reliability of three structural end-range lumbar segmental instability tests with the highest positive Likelihood Ratio against flexion-extension radiographs, and three functional mid-range clinical tests that predict the success of lumbar stabilization exercises in patients with recurrent or chronic low back pain (R/CLBP). It also investigated the reliability of lumbar segmental instability subclassification as: Functional, Structural and Combined Instability. Method: 40 adult with R/CLBP patients (30 men and 10 women), 18 to 80 years of age, underwent repeated measurements of specific clinical tests for structural or functional lumbar segmental instability. Results: Other than the Lack of Hypomobility with PA Glide test, which was found to be unreliable (percentage agreement = 37.5, and k= - 0.02), all the other tests demonstrated high Kappa coefficients and percentage agreements. The sub-classification categories of lumbar segmental instability (functional, structural, and combined) were found to be significantly reliable (k= 0.722, adjusted k= .7 and k =0.84, respectively). Discussion: All the investigated tests (except lack of hypomobility with PA glide test); as well as, the categories of lumbar segmental instability sub-classification, were significantly reliable in predicting lumbar stabilization. Key words: Low back pain, Segmental instability, Reliability, Physical examination, Clinical prediction rule. Discussion:"],"dc:identifier":["https://scholarsrepository.llu.edu/etd/112"],"dc:language":["English"],"dc:rights":["This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights."],"dc:subject":["Physical Therapy","Joint instability; Low Back Pain - diagnosis; Backache; Lumbar vertebrae;","Low back pain","Segmental instability","Reliability","Physical examination","Clinical prediction rule","Lumbar"],"dc:title":["Inter-rater Reliability of Lumbar Segmental Instability Tests and the Subclassification"],"thesis:degree_discipline":["Physical Therapy"],"thesis:degree_level":["Dissertation"],"thesis:degree_name":["Doctor of Science (DSc)"]},"updated_at":"2026-07-24T02:52:15Z"}