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Beau Woods
Neil Thomas
Melinda Stanners
Kelly Holt


Observer Variation, Reliability of Results, Low Back Pain, Lumbar Vertebrae


Objective: To investigate the intra-examiner and inter-examiner reliability of the ‘Objective Synchronous Test’ (OST) as used in Advanced BioStructural Correction™ (ABC™) to assess for dysfunction at the 5th lumbar vertebrae (L5) in participants with and without spine pain, using both experienced and inexperienced ABC™ practitioners.

Methods: Four examiners (2 basic level, 2 instructor level) examined a sample of symptomatic (n = 7) and asymptomatic (n = 16) participants using the OST, which is used as a primary indicator for spinal manipulation of L5 as part of the ABC™ protocol. L5 was tested and retested using the OST as an indicator for correction of L5. The OST was performed on every participant (n=23) by all 4 examiners. Intra-examiner and inter-examiner reliability was reported with observed agreement (Po) and analyzed with kappa (k).

Results: Observed agreement for intra-examiner reliability ranged from 56.5% to 95.7% and averaged 71.8%. Estimates of intra-examiner reliability for L5 ranged from k = 0.13 to 0.91 and were higher than estimates of inter-examiner reliability. Inter-examiner reliability estimates for L5 ranged from k = 0.42 to 0.47. The median observed agreement between paired examiners for L5 ranged from 65.9 to 73.9%.

Conclusion: In this study, the inter-examiner reliability of the OST was generally found to be moderate when assessing for L5 dysfunction. The intra-examiner reliability shown for more experienced (instructor level) examiners was higher than less experienced (basic level) examiners.


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