Inter- and Intra-observer Agreement of the Motion Palpation Test for Lumbar Vertebral Rotational Asymmetry Academic Article uri icon


  • To investigate inter- and intra-observer agreement in the assessment of lumbar vertebral rotational (VR) asymmetry by a motion palpation test.For this prospective and descriptive test-retest study, 51 asymptomatic participants (40 women, 11 men; mean age 23.3 [SD 5.6] years) were recruited from the community. Each participant was assessed in two sessions by the same three observers, who assessed VR by means of a palpatory test for movement asymmetry. This test is performed by applying posteroanterior pressure in an alternating manner to the left and right transverse processes of a vertebra to determine motion asymmetry in the transverse plane and thus the vertebral position. Observers classified the vertebral position as neutral, rotation to the right, and rotation to the left; they were blinded to which participant was being assessed and to any previous results.Intra- and inter-observer agreement was verified by the kappa coefficient (κ) and the weighted kappa coefficient (κ w ). Values of κ and κ w varied from 0.07 (95% CI, -0.10 to 0.245) to 0.37 (95% CI, 0.11-0.63) for intra-observer agreement and from 0.12 (95% CI, -0.06 to 0.29) to 0.30 (95% CI, 0.08-0.52) for inter-observer agreement.The motion palpation test used to assess VR asymmetry has low agreement levels; therefore, its clinical significance for measuring vertebral position is questionable.


  • Bracht, MA
  • Nunes, GS
  • Celestino, J
  • Schwertner, DS
  • Franca, LC
  • de Noronha, M

publication date

  • 2015