Invited commentary on "low interrater reliability of examiners performing the prone instability test: a clinical test for lumbar shear instability".

Abstract

The stated purpose of the article by Ravenna and colleagues is to examine the reliability of the prone instability test (PIT) in the hands of novice clinicians, as previous reliability studies have primarily included more experienced clinicians. They conclude that the interrater reliability for the PIT is low when performing the test as described in the current literature; however, their conclusions should be interpreted cautiously given the significant modifications made to standardize the PIT in their study, as these changes greatly limit the capacity to make direct comparisons to earlier reliability studies of the PIT. The modifications to the PIT used in this study are discussed, including the use of a stabilization belt, alternate positioning of the hips and knees, and the use of a stool for foot placement.