Inter-examiner reproducibility of the segmental motion palpation springing test for side bending at level C2–C3

Abstract

Aim

Reproducibility of the cervical segmental examination has become increasingly important to fulfill indications for the therapeutic interventions common in Manual/Musculoskeletal Medicine. Previous reproducibility studies concerning this topic showed low kappa values, suggesting a low to absent clinical applicability. Due to methodological flaws in previous studies, our objective was to test for reproducibility of our technique of examination of the C2/3 segment using an accepted international protocol.

Method

We used a protocol for reproducibility studies developed by the International Academy for Manual/Musculoskeletal Medicine. The reproducibility of a cervical segmental mobility test at the level C2/C3 was evaluated in a population with cervicogenic headache.

Results

The kappa value for the cervical segmental test on the right side was 0.77 (overall agreement 0.90, prevalence index 0.44) and on the left side was 0.72 (overall agreement 0.86, prevalence index 0.49).

Conclusion

Our study, using an accepted international protocol for reproducibility, guaranteed a proper conclusion about the reproducibility and therefore clinical application of the segmental motion palpation springing test for side bending at level C2–C3. Further studies have to focus on anatomical validation of our test and on developing gold standards for validity studies with respect to the segmental mobility aspect of our clinical examination.

Keywords:

• Segmental mobility
• Reproducibility
• Cervicogenic headache
• Kappa