Intra- and inter-rater reliability of an 11-test package for assessing dysfunction due to back or neck pain

Physiother Res Int. 1999;4(3):214-32. doi: 10.1002/pri.167.


Background and purpose: The intra- and inter-rater reliability of 11 tests assembled by physiotherapists for clinical purposes was investigated. Forty-five patients and 23 healthy volunteers participated in the study.

Method: Twenty-one patients were tested simultaneously and independently by two physiotherapists to determine inter-rater reliability for two raters. Twenty-four patients and 11 healthy volunteers were tested by one physiotherapist three times in a week to determine intra-rater reliability over time. Twelve healthy volunteers were tested by three different physiotherapists in a week to determine inter-rater reliability for three raters.

Results: Inter-rater agreement for two simultaneous raters was clinically acceptable. Repeatability on three test occasions was clinically acceptable in six of the 11 tests. There were no systematic differences between occasions.

Conclusions: Intra- and inter-rater reliability was acceptable for six of the 11 tests in the form described here: three gait tests, two functional lifting tests and a functional muscular endurance test in the right leg. If these tests are to be used as outcome measures, account must be taken of the size of the typical fluctuation in measurements shown. The repeatability figures given may be used as guidelines for interpreting the clinical value of possible changes in test values.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Back Pain / diagnosis*
  • Exercise Tolerance
  • Female
  • Humans
  • Lifting
  • Male
  • Middle Aged
  • Neck Pain / diagnosis*
  • Observer Variation
  • Walking