The interexaminer reproducibility of physical examination of the cervical spine

Abstract 

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.

Keywords:  Agreement, Cervical Spine, Mobility, Reliability, Reproducibility