Limits...
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

Test procedure.
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Fig3: Test procedure.

Mentions: Questionnaires were sent to participants before their first appointment. At the first visit, participants reported NRS (P.P./Week). Examiner C then screened for in- and exclusion criteria, after which SWAY and PPT tests were conducted. Following a rest period of ~2 min., tests for intra- and inter-reliability were performed. Testing order of examiner A and B was randomized for the first test round, and test order was always CCFT, ROM, JPE, GS, SPNTT and DCE. After a rest period of ~2 min. the other examiner performed the same tests in the same order on the same subjects (Figure 3). Duration between the two test occasions was 1–7 days. At the second visit GPE was added, and test order of examiner A and B was reversed. Cases and controls followed the same procedure throughout the testing session.Figure 3


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)

Test procedure.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig3: Test procedure.
Mentions: Questionnaires were sent to participants before their first appointment. At the first visit, participants reported NRS (P.P./Week). Examiner C then screened for in- and exclusion criteria, after which SWAY and PPT tests were conducted. Following a rest period of ~2 min., tests for intra- and inter-reliability were performed. Testing order of examiner A and B was randomized for the first test round, and test order was always CCFT, ROM, JPE, GS, SPNTT and DCE. After a rest period of ~2 min. the other examiner performed the same tests in the same order on the same subjects (Figure 3). Duration between the two test occasions was 1–7 days. At the second visit GPE was added, and test order of examiner A and B was reversed. Cases and controls followed the same procedure throughout the testing session.Figure 3

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