Interexaminer reliability in physical examination of the cervical spine☆

Background: Most of the studies of physical examinations of the cervical spine have shown poor reliability. Purpose: To assess the interexaminer reliability in physical examinations of the cervical spine. Subjects: Forty-eight subjects, age range 18 to 63 years. Methods: Two physiotherapists independently evaluated a number of clinical tests of passive general and intersegmental movement. Results: Acceptable kappa/kappa (w) values were obtained in several of the clinical tests of passive general motion range but in few of the clinical tests of passive inter-segmental movement. More clinical tests had acceptable reliability and less bias in symptomatic subjects than asymptomatic subjects. Conclusion: Many of the clinical tests of passive general motion range were shown to be reliable. The increased number of acceptable kappa (w) values obtained in the symptomatic subjects indicates that further studies of the reliability of the clinical tests of passive intersegmental movement should be performed on patients. (J Manipulative Physiol Ther 1999;22:511–6)