Inter-Rater and Intra-Rater Reliability of the Bowstring Test in Patients with Sciatica

Background: Sciatica is a radiating leg pain that commonly results from compression of the lumbosacral nerve root. Various Clinical tests exist for its diagnosis, but in cases where the slump test cannot be performed, alternative diagnostic methods are required. Objective: To evaluate the inter-rater and intra-rater reliability of the bowstring test in patients with sciatica. Methods: A cross-sectional study was conducted among 45 patients recruited through purposive sampling over a four-month period. Patients with a positive slump test were included and further assessed using the bowstring test. Two raters performed the test on separate occasions, and kappa coefficients were used to determine inter-rater and intra-rater reliability. Results: The inter-rater reliability of the bowstring test showed kappa values of 0.048 and -0.030, indicating poor agreement. Intra-rater reliability demonstrated kappa values of 0.166 and 0.277, reflecting slight to fair agreement, but not statistically significant. Conclusion: The bowstring test did not demonstrate significant inter-rater or intra-rater reliability in diagnosing sciatica. Further studies with larger samples are required to establish its clinical utility.