Research article

Reproducibility of cervical range of motion in patients with neck pain

Jan Lucas Hoving^1,2 , Jan JM Pool¹ , Henk van Mameren³ , Walter JLM Devillé⁴ , Willem JJ Assendelft⁵ , Henrica CW de Vet¹ , Andrea F de Winter⁶ , Bart W Koes⁷ and Lex M Bouter¹

¹Institute for Research in Extramural Medicine, VU University Medical Centre, Amsterdam, the Netherlands

²Department of Clinical Epidemiology, Cabrini Hospital and Monash University Department of Epidemiology and Preventive Medicine, Melbourne, Australia

³Department of Anatomy and Embryology, Faculty of Medicine, Maastricht University, the Netherlands

⁴NIVEL Foundation, Utrecht, The Netherlands

⁵Department of General Practice and Nursing Home Medicine, LUMC Medical Centre, Leiden, the Netherlands

⁶Department of Social Psychiatry, University of Groningen, the Netherlands

⁷Department of General Practice, Erasmus Medical Centre, Rotterdam, the Netherlands

author email corresponding author email

BMC Musculoskeletal Disorders 2005, 6:59doi:10.1186/1471-2474-6-59

Published:	13 December 2005

Abstract

Background

Reproducibility measurements of the range of motion are an important prerequisite for the interpretation of study results. The aim of the study is to assess the intra-rater and inter-rater reproducibility of the measurement of active Range of Motion (ROM) in patients with neck pain using the Cybex Electronic Digital Inclinometer-320 (EDI-320).

Methods

In an outpatient clinic in a primary care setting 32 patients with at least 2 weeks of pain and/or stiffness in the neck were randomly assessed, in a test- retest design with blinded raters using a standardized measurement protocol. Cervical flexion-extension, lateral flexion and rotation were assessed.

Results

Reliability expressed by the Intraclass Correlation Coefficient (ICC) was 0.93 (lateral flexion) or higher for intra-rater reliability and 0.89 (lateral flexion) or higher for inter-rater reliability. The 95% limits of agreement for intra-rater agreement, expressing the range of the differences between two ratings were -2.5 ± 11.1° for flexion-extension, -0.1 ± 10.4° for lateral flexion and -5.9 ± 13.5° for rotation. For inter-rater agreement the limits of agreement were 3.3 ± 17.0° for flexion-extension, 0.5 ± 17.0° for lateral flexion and -1.3 ± 24.6° for rotation.

Conclusion

In general, the intra-rater reproducibility and the inter-rater reproducibility were good. We recommend to compare the reproducibility and clinical applicability of the EDI-320 inclinometer with other cervical ROM measures in symptomatic patients.