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Reliability, construct and discriminative validity of clinical testing in subjects with and without chronic neck pain.

Jørgensen R, Ris I, Falla D, Juul-Kristensen B - BMC Musculoskelet Disord (2014)

Bottom Line: For the test-retest study, ICC was 0.83 to 0.89 for PPT and 0.39 to 0.79 for SWAY.Construct validity was satisfactory for all tests, except JPE.Significant between group discriminative validity was found for CCFT, ROM, GS, SPNTT and PPT, however, differences were within the limits of the minimal detectable change.

View Article: PubMed Central - PubMed

Affiliation: Department of Physiotherapy, University College South Denmark, Esbjerg Ø, Denmark. rejo@ucsyd.dk.

ABSTRACT

Background: The reliability of clinical tests for the cervical spine has not been adequately evaluated. Six cervical clinical tests, which are low cost and easy to perform in clinical settings, were tested for intra- and inter-examiner reliability, and two performance tests were assessed for test-retest reliability in people with and without chronic neck pain. Moreover, construct and between-group discriminative validity of the tests were examined.

Methods: Twenty-one participants with chronic neck pain and 21 asymptomatic participants were included. Intra- and inter-reliability were evaluated for the Cranio-Cervical Flexion Test (CCFT), Range of Movement (ROM), Joint Position Error (JPE), Gaze Stability (GS), Smooth Pursuit Neck Torsion Test (SPNTT), and neuromuscular control of the Deep Cervical Extensors (DCE). Test-retest reliability was assessed for Postural Control (SWAY) and Pressure Pain Threshold (PPT) over tibialis anterior, infraspinatus and the C3-C4 segment.

Results: Intraclass Correlation Coefficient (ICC) for intra- and inter-examiner reliability was highest for ROM (range: 0.80 to 0.94), DCE (0.75 to 0.90) and CCFT (0.63 to 0.86). JPE had the lowest ICC (0.02 to 0.66). Intra- and inter-reliability for GS and SPNTT showed kappa ranging from 0.66 to 0.92, and 0.57 to 0.78 (prevalence adjusted), respectively. For the test-retest study, ICC was 0.83 to 0.89 for PPT and 0.39 to 0.79 for SWAY. Construct validity was satisfactory for all tests, except JPE. Significant between group discriminative validity was found for CCFT, ROM, GS, SPNTT and PPT, however, differences were within the limits of the minimal detectable change.

Conclusions: The majority of the tests evaluated showed satisfactory reliability and construct validity supporting their use in the clinical evaluation of patients with chronic neck pain.

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Related in: MedlinePlus

Participant flow and retention.
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Fig1: Participant flow and retention.

Mentions: Exclusion criteria for both groups: neuropathies/radiculopathies (defined by positive Spurling, cervical traction and plexus brachialis tests) [31], neurological deficits, being in an unstable social and/or working situation, pregnancy, known fractures, and depression according to the Beck Depression Inventory (BDI) (score >29) [32].Overall, 31 patients with chronic neck pain were recruited, and 21 were included in the final sample (Figure 1). All 21 controls were matched on gender and age (+/-3 years). Subjects received oral and written information about the project and gave their written informed consent to participate. The Regional Scientific Ethical Committee of Southern Denmark approved the study (S-20100069). The study conformed to The Declaration of Helsinki 2008.Figure 1


Reliability, construct and discriminative validity of clinical testing in subjects with and without chronic neck pain.

Jørgensen R, Ris I, Falla D, Juul-Kristensen B - BMC Musculoskelet Disord (2014)

Participant flow and retention.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4325947&req=5

Fig1: Participant flow and retention.
Mentions: Exclusion criteria for both groups: neuropathies/radiculopathies (defined by positive Spurling, cervical traction and plexus brachialis tests) [31], neurological deficits, being in an unstable social and/or working situation, pregnancy, known fractures, and depression according to the Beck Depression Inventory (BDI) (score >29) [32].Overall, 31 patients with chronic neck pain were recruited, and 21 were included in the final sample (Figure 1). All 21 controls were matched on gender and age (+/-3 years). Subjects received oral and written information about the project and gave their written informed consent to participate. The Regional Scientific Ethical Committee of Southern Denmark approved the study (S-20100069). The study conformed to The Declaration of Helsinki 2008.Figure 1

Bottom Line: For the test-retest study, ICC was 0.83 to 0.89 for PPT and 0.39 to 0.79 for SWAY.Construct validity was satisfactory for all tests, except JPE.Significant between group discriminative validity was found for CCFT, ROM, GS, SPNTT and PPT, however, differences were within the limits of the minimal detectable change.

View Article: PubMed Central - PubMed

Affiliation: Department of Physiotherapy, University College South Denmark, Esbjerg Ø, Denmark. rejo@ucsyd.dk.

ABSTRACT

Background: The reliability of clinical tests for the cervical spine has not been adequately evaluated. Six cervical clinical tests, which are low cost and easy to perform in clinical settings, were tested for intra- and inter-examiner reliability, and two performance tests were assessed for test-retest reliability in people with and without chronic neck pain. Moreover, construct and between-group discriminative validity of the tests were examined.

Methods: Twenty-one participants with chronic neck pain and 21 asymptomatic participants were included. Intra- and inter-reliability were evaluated for the Cranio-Cervical Flexion Test (CCFT), Range of Movement (ROM), Joint Position Error (JPE), Gaze Stability (GS), Smooth Pursuit Neck Torsion Test (SPNTT), and neuromuscular control of the Deep Cervical Extensors (DCE). Test-retest reliability was assessed for Postural Control (SWAY) and Pressure Pain Threshold (PPT) over tibialis anterior, infraspinatus and the C3-C4 segment.

Results: Intraclass Correlation Coefficient (ICC) for intra- and inter-examiner reliability was highest for ROM (range: 0.80 to 0.94), DCE (0.75 to 0.90) and CCFT (0.63 to 0.86). JPE had the lowest ICC (0.02 to 0.66). Intra- and inter-reliability for GS and SPNTT showed kappa ranging from 0.66 to 0.92, and 0.57 to 0.78 (prevalence adjusted), respectively. For the test-retest study, ICC was 0.83 to 0.89 for PPT and 0.39 to 0.79 for SWAY. Construct validity was satisfactory for all tests, except JPE. Significant between group discriminative validity was found for CCFT, ROM, GS, SPNTT and PPT, however, differences were within the limits of the minimal detectable change.

Conclusions: The majority of the tests evaluated showed satisfactory reliability and construct validity supporting their use in the clinical evaluation of patients with chronic neck pain.

Show MeSH
Related in: MedlinePlus