Mehrnaz Kajbafvala1, Ismail Ebrahimi-Takamjani2, Mahyar Salavati3, Ahmad Saeedi4, Mohammad Reza Pourahmadi1, Zinat Ashnagar5, Mohammad Jafar Shaterzadeh-Yazdi6, Ali Amiri1. 1. Department of Physical Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. 2. Department of Physical Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Electronic address: dr_i_ebrahimi@yahoo.com. 3. Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. 4. Department of Statistical Research and Information Technology, Institute for Research and Planning in Higher Education, Tehran, Iran. 5. Department of Physical Therapy, Rehabilitation Faculty, Tehran University of Medical Sciences, Tehran, Iran. 6. Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Abstract
BACKGROUND: The methods to standardize the test items used for classification of patients with knee pain based on the movement system impairment (MSI) approach have been established. To our knowledge, no study has concentrated on establishing reliability for proposed classification for knee pain problems. OBJECTIVE: The aim of the study was to assess intra- and intertester reliability of the knee MSI classification in patients with knee pain. DESIGN: A cross-sectional methodological study. SETTING: Rasul Akram Hospital. PARTICIPANTS: Ninety-six subjects with knee pain aged 18-65 years. METHODS: In order to examine intertester reliability, all three testers assessed the symptoms, signs and the MSI diagnosis of subjects with knee pain simultaneously. In order to assess intratester reliability, the procedure was exactly repeated after a one-week intersession period. Kappa values and percentages of agreement were calculated to analyze the reliability level. RESULTS: The kappa values for intra- and intertester reliability of the symptom items ranged from 0.83 to 1.00 and 0.00 to 0.83, respectively. For the sign items, the kappa values ranged from 0.18 to 1.00 and 0.00 to 0.82, respectively. Finally, the kappa values of intra- and intertester reliability for patients' classification judgments ranged from 0.66 to 0.71, and 0.48 to 0.58, respectively. CONCLUSION: The results of the present study indicate that intertester reliability for the symptoms, signs and classification judgments of patients with knee pain based on the MSI approach seemed generally acceptable. However, for intratester reliability, lower levels of the system were observed, probably due to different pain levels or pain behavior between test and retest sessions.
BACKGROUND: The methods to standardize the test items used for classification of patients with knee pain based on the movement system impairment (MSI) approach have been established. To our knowledge, no study has concentrated on establishing reliability for proposed classification for knee pain problems. OBJECTIVE: The aim of the study was to assess intra- and intertester reliability of the knee MSI classification in patients with knee pain. DESIGN: A cross-sectional methodological study. SETTING: Rasul Akram Hospital. PARTICIPANTS: Ninety-six subjects with knee pain aged 18-65 years. METHODS: In order to examine intertester reliability, all three testers assessed the symptoms, signs and the MSI diagnosis of subjects with knee pain simultaneously. In order to assess intratester reliability, the procedure was exactly repeated after a one-week intersession period. Kappa values and percentages of agreement were calculated to analyze the reliability level. RESULTS: The kappa values for intra- and intertester reliability of the symptom items ranged from 0.83 to 1.00 and 0.00 to 0.83, respectively. For the sign items, the kappa values ranged from 0.18 to 1.00 and 0.00 to 0.82, respectively. Finally, the kappa values of intra- and intertester reliability for patients' classification judgments ranged from 0.66 to 0.71, and 0.48 to 0.58, respectively. CONCLUSION: The results of the present study indicate that intertester reliability for the symptoms, signs and classification judgments of patients with knee pain based on the MSI approach seemed generally acceptable. However, for intratester reliability, lower levels of the system were observed, probably due to different pain levels or pain behavior between test and retest sessions.