痛みと緩和のジャーナル

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Inter-rater Reliability of Needle Electromyographic Findings in Patients with Sciatica

Nathan J. Savage*, Julie M. Fritz, Richard P. Nielsen and Jeffrey Fraser

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.