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Physical Therapists Measure Reliability of Neck Testing
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Posted on: 10/26/2006
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In this study, physical therapists (PTs) measure how reliable their history and physical examination (HP&E) are for patients with mechanical neck pain. Test measures that give the same information no matter which PT performs the test are considered reliable. PTs use the results of HP&E to diagnose the problem and plan the treatment.
Tests used included posture, neck motion, muscle strength, and flexibility. Each test is described in detail. Twenty-two (22) patients with neck pain were examined by two different physical therapists using the same tests. There was a five-minute break between each half-hour test session.
The authors report poor reliability when testing neck rotation and side bending motions. There was zero to moderate agreement in testing strength of the lower trapezius muscle.
Assessing movement or mobility of each neck segment was also a problem. Results varied quite a bit between the two PTs testing each patient. It's possible the test is reliable but finding the correct segment or level of the cervical spine is difficult. More study is needed before these test measures are used to guide treatment.
The tests that were considered reliable included:
Active neck flexion and extension
Posture
Flexibility
Strength of the rhomboid muscles
Finding ways to classify neck pain patients into subgroups may help PTs treat these patients successfully. H&PE are important parts of the decision-making process. Reliability data from this study may help PTs choose which tests to conduct during an exam.
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References:
Joshua A. Cleland, DPT, PhD, OCS, et al. Interrater Reliability of the History and Physical Examination in Patients with Mechanical Neck Pain. In Archives of Physical Medicine and Rehabilitation. October 2006. Vol. 87. No. 10. Pp. 1388-1395.
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