Email updates

Keep up to date with the latest news and content from BMC Musculoskeletal Disorders and BioMed Central.

Open Access Highly Accessed Research article

Reliability and group differences in quantitative cervicothoracic measures among individuals with and without chronic neck pain

Bahar Shahidi1, Cynthia L Johnson2, Douglas Curran-Everett3 and Katrina S Maluf45*

Author Affiliations

1 Physical Therapy Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

2 Physical Therapy Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

3 Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, CO, USA

4 Physical Therapy Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

5 Department of Physical Medicine & Rehabilitation Physical Therapy Program, University of Colorado Anschutz Medical Campus, MS C244 Education 2 South. Bldg #L28 13121 E. 17th Ave, Room 3108, Aurora, CO, 80045, USA

For all author emails, please log on.

BMC Musculoskeletal Disorders 2012, 13:215  doi:10.1186/1471-2474-13-215

Published: 31 October 2012

Abstract

Background

Clinicians frequently rely on subjective categorization of impairments in mobility, strength, and endurance for clinical decision-making; however, these assessments are often unreliable and lack sensitivity to change. The objective of this study was to determine the inter-rater reliability, minimum detectable change (MDC), and group differences in quantitative cervicothoracic measures for individuals with and without chronic neck pain (NP).

Methods

Nineteen individuals with NP and 20 healthy controls participated in this case control study. Two physical therapists performed a 30-minute examination on separate days. A handheld dynamometer, gravity inclinometer, ruler, and stopwatch were used to quantify cervical range of motion (ROM), cervical muscle strength and endurance, and scapulothoracic muscle length and strength, respectively.

Results

Intraclass correlation coefficients for inter-rater reliability were significantly greater than zero for most impairment measures, with point estimates ranging from 0.45 to 0.93. The NP group exhibited reduced cervical ROM (P ≤ 0.012) and muscle strength (P ≤ 0.038) in most movement directions, reduced cervical extensor endurance (P = 0.029), and reduced rhomboid and middle trapezius muscle strength (P ≤ 0.049).

Conclusions

Results demonstrate the feasibility of obtaining objective cervicothoracic impairment measures with acceptable inter-rater agreement across time. The clinical utility of these measures is supported by evidence of impaired mobility, strength, and endurance among patients with NP, with corresponding MDC values that can help establish benchmarks for clinically significant change.

Keywords:
Scapular strength; Reliability; Neck pain; Cervical; Thoracic