Reliability and discriminative validity of a screening tool for the assessment of neuromuscular control and movement control in patients with neck pain and healthy individuals

Abstract

Background

To evaluate the reliability and discriminative validity of a proposed adapted tool for the assessment of movement control in patients with and without neck pain.

Method

A cross-sectional study at a University hospital center involving 25 pain-free healthy controls and 25 patients suffering from neck pain. Participants were assessed by two raters for inter-rater reliability and 1 week afterwards by a same rater for intra-rater reliability. The assessment involved a test for the axioscapular (adapted scapular holding test; SHT) and craniocervical (adapted craniocervical flexion test; CCFT) region for which intra-class correlation coefficients (ICCs) were computed to define the reliability. Discriminative validity to distinguish patients from controls was assessed by cross-validated computation of sensitivity, specificity, positive and negative likelihood ratios, overall accuracy, and area under the curve.

Results

The proposed tool was able to reliably assess sensorimotor impairment in participants at the craniocervical region (ICC_intra = [0.52–0.82]; ICC_inter = [0.60–0.85]), left axioscapular region (ICC_intra = [0.43–0.77]; ICC_inter = 0.71–0.90), and right axioscapular region (ICC_intra = [0.47–0.79]; ICC_inter = [0.42–0.77]). Furthermore, the tool yielded a sensitivity of 0.86, a specificity of 0.57, and accuracy of 0.71 (based on cross-validation).

Conclusion

The proposed tool is able to reliably evaluate patients based on their sensorimotor performance in the craniocervical and axioscapular region.

Implications for rehabilitation

• Neck pain is related to sensorimotor impairment including neuromuscular differences and atypical sensormimotor control strategies.

• Clinicians should not avoid the challenging task of screening for sensorimotor impairment in patients reporting neck pain.

• The proposed tool supplemented with other tools might guide clinicians in the evaluation of sensorimotor impairment.

Keywords:

• Neck pain
• sensorimotor control
• discriminative validity
• reliability

Acknowledgements

We would like to acknowledge the participants that voluntarily participated in this study and the physiotherapists, Margo De Nys and Fien De Schrijver, who have screened all participants that were enrolled in this study.

Disclosure statement

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.