The interexaminer reproducibility of physical examination of the cervical spine

  • Pool J
  • Hoving J
  • De Vet H
 et al. 
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Objective: To assess the interexaminer reproducibility of physical examination of the cervical spine. Methods: Two physiotherapists independently judged the general mobility and the intersegmental mobility (segments C0-T2) of the neck and the pain that was provoked. Percentage agreement and Cohen's κ expressed agreement of dichotomous variables; limits of agreement expressed agreement of continuous variables; and intraclass correlation coefficients (ICCs) expressed the reliability of continuous variables. Results: Agreement for general mobility showed κ between 0.05 and 0.61, and for the intersegmental mobility, it showed κ values between -0.09 and 0.63. Agreement for provoked neck pain within 1 point of an 11-point numerical rating scale (NRS) varied between 46.9% and 65.7% for general mobility and between 40.7% and 75.0% for intersegmental mobility. The ICCs varied between 0.36 and 0.71 for general mobility and between 0.22 and 0.80 for intersegmental mobility. Conclusions: Despite the use of a standardized protocol to assess general mobility and intersegmental mobility of the cervical spine, it is difficult to achieve reasonable agreement and reliability between 2 examiners. Likewise, the patients are not able to score the same level of provoked pain in 2 assessments with an interval of 15 minutes.

Author-supplied keywords

  • Agreement
  • Cervical Spine
  • Mobility
  • Reliability
  • Reproducibility

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  • Jan PoolHogeschool Utrecht

  • Jan L. Hoving

  • Henrica C. De Vet

  • Henk Van Mameren

  • Lex M. Bouter

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