Inter-rater Reliability of Needle Electromyographic Findings in Patients with Sciatica
|Nathan J. Savage1*, Julie M. Fritz2, Richard P. Nielsen3 and Jeffrey Fraser4|
|1Clinical Faculty, Department of Physical Therapy, University of Utah, Salt Lake City, Utah, USA|
|2Faculty, Department of Physical Therapy, University of Utah, Salt Lake City, Utah, USA|
|3President, Rocky Mountain University of Health Professions, Provo, Utah, USA|
|4Director of Electrophysiology and Intraoperative Monitoring, Human Performance and Rehabilitation Centers, Columbus, GA, USA|
|Corresponding Author :||Nathan J. Savage
Total Rehab, Inc. 5957 South Fashion Point Drive
Suite 102 South Ogden, Utah 84403, USA
Tel: (801) 827-0200
Fax: (801) 827-0201
E-mail: [email protected]
|Received September 27, 2014; Accepted October 22, 2014; Published October 24, 2014|
|Citation: Savage NJ, Fritz JM, Nielsen RP, Fraser J (2014) Inter-rater Reliability of Needle Electromyographic Findings in Patients with Sciatica. J Pain Relief 3:159. doi: 10.4172/2167-0846.1000159|
|Copyright: © 2014 Savage NJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Purpose: Investigate inter-rater reliability of needle electromyographic findings among experienced physical therapist electromyographers.
Methods: Masked review of 24 electromyographic recordings from patients with sciatica referred to physical therapy was undertaken. An examiner unmasked to patient history and physical examination findings digitally recorded and stored insertional and resting electromyographic activity as de-identified digital audio-video files to be analyzed by 2 masked examiners. Examiners provided ratings for individual muscles and overall electrodiagnostic impression. Agreement was assessed using Cohen’s kappa (κ) statistics.
Results: Examiner agreement for insertional and resting electromyographic activity for all muscles combined was substantial (κ ≥ 0.68, 95% CI: 0.50 to 0.89; P≤.001), ranging from fair (κ=0.33, 95% CI: -0.25 to 1.0; P>.05) to perfect (κ=1.0, 95% CI: 1.0 to 1.0; P≤.001) for individual muscles examined. Pairwise examiner comparisons revealed moderate (κ=0.43, 95% CI: 0.11 to 0.76; P=.01) to substantial (κ=0.75, 95% CI: 0.48 to 1.0; P<.0001) agreement for the final electrodiagnostic impression and fair (κw=0.31, 95% CI: 0.12 to 0.50; P=0.004) to substantial (κw=0.62, 95% CI: 0.37 to 0.87; P<.0001) agreement for the overall electrodiagnostic impression.
Conclusions: Needle electromyographic activity can be reliably assessed among experienced physical therapist electromyographers in patients with sciatica referred to physical therapy.