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

BMC Musculoskeletal Disorders

Katrina S Maluf³  Douglas Curran-Everett¹  Cynthia L Johnson²  Bahar Shahidi² 

[1] Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, CO, USA;Physical Therapy Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA;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

关键词: Thoracic;    Cervical;    Neck pain;    Reliability;    Scapular strength;   

Others  :  1135734
DOI  :  10.1186/1471-2474-13-215

 received in 2012-06-11, accepted in 2012-10-26,  发布年份 2012

【 摘 要 】

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.

【 授权许可】

   
2012 Shahidi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Figure 6.

【 参考文献 】

• [1]Hogg-Johnson S, van der Velde G, Carroll LJ, et al.: The burden and determinants of neck pain in the general population: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and its Associated Disorders. J Manip Physiol Ther 2009, 32(2 Suppl):S46-60.
• [2]Cote P, van der Velde G, Cassidy JD, et al.: The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. J Manip Physiol Ther 2009, 32(2 Suppl):S70-86.
• [3]Misailidou V, Malliou P, Beneka A, Karagiannidis A, Godolias G: Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools. J Chiropr Med. 2010, 9(2):49-59.
• [4]Manchikanti L, Singh V, Datta S, Cohen SP, Hirsch JA: Comprehensive review of epidemiology, scope, and impact of spinal pain. Pain Physician. 2009, 12(4):E35-70.
• [5]de Koning CH, van den Heuvel SP, Staal JB, Smits-Engelsman BC, Hendriks EJ: Clinimetric evaluation of methods to measure muscle functioning in patients with non-specific neck pain: a systematic review. BMC Musculoskelet Disord 2008, 9:142. BioMed Central Full Text
• [6]Nordin M, Carragee EJ, Hogg-Johnson S, et al.: Assessment of neck pain and its associated disorders: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine 2008, 33(4 Suppl):S101-122.
• [7]Williams MA, McCarthy CJ, Chorti A, Cooke MW, Gates S: A systematic review of reliability and validity studies of methods for measuring active and passive cervical range of motion. J Manip Physiol Ther 2010, 33(2):138-155.
• [8]Cleland JA, Childs JD, Fritz JM, Whitman JM: Interrater reliability of the history and physical examination in patients with mechanical neck pain. Arch Phys Med Rehabil 2006, 87(10):1388-1395.
• [9]Cadogan A, Laslett M, Hing W, McNair P, Williams M: Reliability of a new hand-held dynamometer in measuring shoulder range of motion and strength. Man Ther 2011, 16(1):97-101.
• [10]Hoving JL, Pool JJ, van Mameren H, et al.: Reproducibility of cervical range of motion in patients with neck pain. BMC Musculoskelet Disord 2005, 6:59. BioMed Central Full Text
• [11]Harris KD, Heer DM, Roy TC, Santos DM, Whitman JM, Wainner RS: Reliability of a measurement of neck flexor muscle endurance. Phys Ther 2005, 85(12):1349-1355.
• [12]Kendall FP, McCreary EK, Provance PG, Rodgers MM, Romani WA: Muscles testing and function with posture and pain. 5th edition. MD Lippincott Williams & Wilkins: Baltimore; 2005.
• [13]Wadsworth CT, Krishnan R, Sear M, Harrold J, Nielsen DH: Intrarater reliability of manual muscle testing and hand-held dynametric muscle testing. Phys Ther 1987, 67(9):1342-1347.
• [14]Wegner S, Jull G, O'Leary S, Johnston V: The effect of a scapular postural correction strategy on trapezius activity in patients with neck pain. Man Ther 2010, 15(6):562-566.
• [15]Sahrmann SA: Movement system impairment syndromes of the extremities, cervical and thoracic spines. St. Louis, MO: Elsevier; 2011.
• [16]Petersen SM, Wyatt SN: Lower trapezius muscle strength in individuals with unilateral neck pain. J Orthop Sports Phys Ther 2011, 41(4):260-265.
• [17]Vernon H, Mior S: The Neck Disability Index: a study of reliability and validity. J Manip Physiol Ther 1991, 14(7):409-415.
• [18]Guzman J, Haldeman S, Carroll L: Clinical practice implications of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and its Associated Disorders: from concepts and findings to recommendations. Spine 2008, 33(4S):S199-S233.
• [19]Phillips BA, Lo SK, Mastaglia FL: Muscle force measured using "break" testing with a hand-held myometer in normal subjects aged 20 to 69 years. Arch Phys Med Rehabil 2000, 81(5):653-661.
• [20]Edmondston SJ, Wallumrod ME, Macleid F, Kvamme LS, Joebges S, Brabham GC: Reliability of isometric muscle endurance tests in subjects with postural neck pain. J Manip Physiol Ther 2008, 31(5):348-354.
• [21]Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics 1977, 33(1):159-174.
• [22]Beaton DE: Understanding the relevance of measured change through studies of responsiveness. Spine 2000, 25(24):3192-3199.
• [23]Olson LE, Millar AL, Dunker J, Hicks J, Glanz D: Reliability of a clinical test for deep cervical flexor endurance. J Manip Physiol Ther 2006, 29(2):134-138.
• [24]Domenech MA, Sizer PS, Dedrick GS, McGalliard MK, Brismee JM: The deep neck flexor endurance test: normative data scores in healthy adults. PM R. 2011, 3(2):105-110.
• [25]Chiu TT, Sing KL: Evaluation of cervical range of motion and isometric neck muscle strength: reliability and validity. Clin Rehabil 2002, 16(8):851-858.
• [26]Viikari-Juntura E: Interexaminer reliability of observations in physical examinations of the neck. Phys Ther 1987, 67(10):1526-1532.
• [27]Gray's A: The Anatomical Basis of Clinical Practice. 40th edition. Churchill-Livingstone: Elsevier; 2008.
• [28]Cagnie B, Cools A, De Loose V, Cambier D, Daneels L: Differences in isometric neck muscle strength between healthy controls and women with chronic neck pain: the use of a reliable measurement. Arch Phys Med Rehabil 2007, 88(11):1441-1445.
• [29]Lecompte J, Maisetti O, Guillaume A, Skalli W, Portero P: Neck strength and EMG activity in fighter pilots with episodic neck pain. Aviat Space Environ Med. 2008, 79(10):947-952.
• [30]Edmondston S, Bjornsdottir G, Palsson T, Solgard H, Ussing K, Allison G: Endurance and fatigue characteristics of the neck flexor and extensor muscles during isometric tests in patients with postural neck pain. Man Ther 2011, 16(4):332-338.