Inter-rater reliability of select physical examination procedures in patients with neck pain

Abstract

This study evaluated the inter-rater reliability of select examination procedures in patients with neck pain (NP) conducted over a 24- to 48-h period. Twenty-two patients with mechanical NP participated in a standardized examination. One examiner performed standardized examination procedures and a second blinded examiner repeated the procedures 24–48 h later with no treatment administered between examinations. Inter-rater reliability was calculated with the Cohen Kappa and weighted Kappa for ordinal data while continuous level data were calculated using an intraclass correlation coefficient model 2,1 (ICC_2,1). Coefficients for categorical variables ranged from poor to moderate agreement (−0.22 to 0.70 Kappa) and coefficients for continuous data ranged from slight to moderate (ICC_2,1 0.28–0.74). The standard error of measurement for cervical range of motion ranged from 5.3° to 9.9° while the minimal detectable change ranged from 12.5° to 23.1°. This study is the first to report inter-rater reliability values for select components of the cervical examination in those patients with NP performed 24–48 h after the initial examination. There was considerably less reliability when compared to previous studies, thus clinicians should consider how the passage of time may influence variability in examination findings over a 24- to 48-h period.

• Examination
• neck pain
• reliability