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Published in: BMC Musculoskeletal Disorders 1/2014

Open Access 01-12-2014 | Research article

Reliability of movement control tests on the cervical spine

Authors: Maja Patroncini, Susanne Hannig, André Meichtry, Hannu Luomajoki

Published in: BMC Musculoskeletal Disorders | Issue 1/2014

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Abstract

Background

Movement control impairment reduces active control of movement. Patients with this might form an important subgroup among patients with mechanical cervical pain. Diagnosis is based on the observation of active movement tests. Although widely used clinically, few studies have been performed to determine the reliability of a test battery. The aim of this study was to determine the inter-tester reliability of movement control impairment [MCI] tests on the cervical spine.

Methods

Forty-five subjects (31 patients with neck pain, 14 healthy controls) were videotaped while performing a standardized test battery consisting of 13 tests of active movement control. Using observation, two experienced physiotherapists independently rated test performances as correct or incorrect. One of them was blinded to all other patient information and both to each other. Kappa coefficients and 95% confidence intervals [CI] for inter-tester results were calculated.

Results

The kappa values for inter-tester reliability ranged in from 0.47-1.0 of the 13 tests, 2 demonstrated perfect reliability (k = 1.0), 4 excellent (k 0.81-0.99), 6 substantial (k 0.61-0.8) and 1 good (k 0.41-0.6).

Conclusions

The physiotherapists were able reliably rate the majority the tests in this series of motor control tasks. There have been studies performed describing the assessment and treatment of movement control impairment problems and low back pain. However, no study has involved the assessment of the cervical dysfunction subgroup. This study presents a reliable test battery, for clinical use, to perform more specific examination of this subgroup.
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Literature
1.
go back to reference Côté P, Cassidy JD, Carroll L: The epidemiology of neck pain: what we have learned from our population-based studies. J Can Ciropr Assoc. 2003, 74 (4): 284-290. Côté P, Cassidy JD, Carroll L: The epidemiology of neck pain: what we have learned from our population-based studies. J Can Ciropr Assoc. 2003, 74 (4): 284-290.
2.
go back to reference Haldeman S, Carroll L, Cassidy JD, Schubert J, Nygren A, Disorders B. a. J. D.-T. F. o. N. P. a. I. A: The Bone and Joint Decade 2000–2010 task force on neck pain and its associated disorders: executive summary. Spine (Phila Pa 1976). 2008, 33 (4 Suppl): S5-S7. doi:10.1097/BRS.0b013e3181643f40CrossRef Haldeman S, Carroll L, Cassidy JD, Schubert J, Nygren A, Disorders B. a. J. D.-T. F. o. N. P. a. I. A: The Bone and Joint Decade 2000–2010 task force on neck pain and its associated disorders: executive summary. Spine (Phila Pa 1976). 2008, 33 (4 Suppl): S5-S7. doi:10.1097/BRS.0b013e3181643f40CrossRef
3.
go back to reference Jull G, Sterling M, Falla D, Treleaven J, O’Leary S: Whiplash, Headache, and Neck Pain. 2008, London: Elsevier Churchill Livingstone Jull G, Sterling M, Falla D, Treleaven J, O’Leary S: Whiplash, Headache, and Neck Pain. 2008, London: Elsevier Churchill Livingstone
4.
go back to reference O’Sullivan P: Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism. Man Ther. 2010, 10 (4): 242-255. doi:10.1016/j.math.2005.07.001CrossRef O’Sullivan P: Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism. Man Ther. 2010, 10 (4): 242-255. doi:10.1016/j.math.2005.07.001CrossRef
5.
go back to reference Luomajoki H: Movement Control Impairment as a Sub-group of Non-specific Low Back Pain. 2010, Kuopio: University of Eastern Finland Luomajoki H: Movement Control Impairment as a Sub-group of Non-specific Low Back Pain. 2010, Kuopio: University of Eastern Finland
6.
go back to reference Falla D, Bilenkij G, Jull G: Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task. Spine (Phila Pa 1976). 2004, 29 (13): 1436-1440. 10.1097/01.BRS.0000128759.02487.BF. doi:00007632-200407010-00011CrossRef Falla D, Bilenkij G, Jull G: Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task. Spine (Phila Pa 1976). 2004, 29 (13): 1436-1440. 10.1097/01.BRS.0000128759.02487.BF. doi:00007632-200407010-00011CrossRef
7.
go back to reference Falla D, Jull G, Hodges PW: Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. Exp Brain Res. 2004, 157 (1): 43-48. 10.1007/s00221-003-1814-9. doi:10.1007/s00221-003-1814-9CrossRefPubMed Falla D, Jull G, Hodges PW: Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. Exp Brain Res. 2004, 157 (1): 43-48. 10.1007/s00221-003-1814-9. doi:10.1007/s00221-003-1814-9CrossRefPubMed
8.
go back to reference Moseley GL, Hodges PW: Chronic pain and motor control. Grieve’s Modern Manual Therapy, The vertebral column. Edited by: Boyling JD, Jull GA. 2004, London: Churchill Livingstone, 215-231. 3 Moseley GL, Hodges PW: Chronic pain and motor control. Grieve’s Modern Manual Therapy, The vertebral column. Edited by: Boyling JD, Jull GA. 2004, London: Churchill Livingstone, 215-231. 3
9.
go back to reference Sahrmann SA: Diagnosis and Treatment of Movement Impairment Syndromes. 2002, St.Louis: Mosby Sahrmann SA: Diagnosis and Treatment of Movement Impairment Syndromes. 2002, St.Louis: Mosby
10.
go back to reference McDonnell MK: Movement System Syndromes of the Cervical Spine. Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines. Edited by: Sahrmann S. 2011, St. Louis: Elsevier Mosby, 1 McDonnell MK: Movement System Syndromes of the Cervical Spine. Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines. Edited by: Sahrmann S. 2011, St. Louis: Elsevier Mosby, 1
11.
go back to reference Dankaerts W, O’Sullivan PB, Straker LM, Burnett AF, Skouen JS: The inter-examiner reliability of a classification method for non-specific chronic low back pain patients with motor control impairment. Man Ther. 2006, 11 (1): 28-39. 10.1016/j.math.2005.02.001. doi:10.1016/j.math.2005.02.001CrossRefPubMed Dankaerts W, O’Sullivan PB, Straker LM, Burnett AF, Skouen JS: The inter-examiner reliability of a classification method for non-specific chronic low back pain patients with motor control impairment. Man Ther. 2006, 11 (1): 28-39. 10.1016/j.math.2005.02.001. doi:10.1016/j.math.2005.02.001CrossRefPubMed
12.
go back to reference Luomajoki H, Kool J, de Bruin ED, Airaksinen O: Reliability of movement control tests in the lumbar spine. BMC Musculoskelet Disord. 2007, 8: 90-10.1186/1471-2474-8-90. doi:10.1186/1471-2474-8-90CrossRefPubMedPubMedCentral Luomajoki H, Kool J, de Bruin ED, Airaksinen O: Reliability of movement control tests in the lumbar spine. BMC Musculoskelet Disord. 2007, 8: 90-10.1186/1471-2474-8-90. doi:10.1186/1471-2474-8-90CrossRefPubMedPubMedCentral
13.
go back to reference Luomajoki H, Kool J, de Bruin ED, Airaksinen O: Movement control tests of the low back; evaluation of the difference between patients with low back pain and healthy controls. BMC Musculoskelet Disord. 2008, 9: 170-10.1186/1471-2474-9-170. doi:10.1186/1471-2474-9-170CrossRefPubMedPubMedCentral Luomajoki H, Kool J, de Bruin ED, Airaksinen O: Movement control tests of the low back; evaluation of the difference between patients with low back pain and healthy controls. BMC Musculoskelet Disord. 2008, 9: 170-10.1186/1471-2474-9-170. doi:10.1186/1471-2474-9-170CrossRefPubMedPubMedCentral
14.
go back to reference Luomajoki H, Kool J, de Bruin ED, Airaksinen O: Improvement in low back movement control, decreased pain and disability, resulting from specific exercise intervention. Sports Med Arthrosc Rehabil Ther Technol. 2010, 2: 11-10.1186/1758-2555-2-11. doi:10.1186/1758-2555-2-11PubMedPubMedCentral Luomajoki H, Kool J, de Bruin ED, Airaksinen O: Improvement in low back movement control, decreased pain and disability, resulting from specific exercise intervention. Sports Med Arthrosc Rehabil Ther Technol. 2010, 2: 11-10.1186/1758-2555-2-11. doi:10.1186/1758-2555-2-11PubMedPubMedCentral
15.
go back to reference Carlsson H, Rasmussen-Barr E: Clinical screening test for assessing movement control in non-specific low-back pain. a systematic review of intra- and inter-observer reliability studies. Man Ther. 2013, 18: 103-110. 10.1016/j.math.2012.08.004.CrossRefPubMed Carlsson H, Rasmussen-Barr E: Clinical screening test for assessing movement control in non-specific low-back pain. a systematic review of intra- and inter-observer reliability studies. Man Ther. 2013, 18: 103-110. 10.1016/j.math.2012.08.004.CrossRefPubMed
16.
go back to reference Niere KR, Torney SK: Clinicians’ perceptions of minor cervical instability. Man Ther. 2004, 9 (3): 144-150. 10.1016/S1356-689X(03)00100-0. doi:10.1016/S1356-689X(03)00100-0CrossRefPubMed Niere KR, Torney SK: Clinicians’ perceptions of minor cervical instability. Man Ther. 2004, 9 (3): 144-150. 10.1016/S1356-689X(03)00100-0. doi:10.1016/S1356-689X(03)00100-0CrossRefPubMed
17.
go back to reference O’Leary S, Falla D, Elliott JM, Jull G: Muscle dysfunction in cervical spine pain: implications for assessment and management. J Orthop Sports Phys Ther. 2009, 39 (5): 324-333. 10.2519/jospt.2009.2872. doi:10.2519/jospt.2009.2872CrossRefPubMed O’Leary S, Falla D, Elliott JM, Jull G: Muscle dysfunction in cervical spine pain: implications for assessment and management. J Orthop Sports Phys Ther. 2009, 39 (5): 324-333. 10.2519/jospt.2009.2872. doi:10.2519/jospt.2009.2872CrossRefPubMed
18.
go back to reference Jasiewicz JM, Treleaven J, Condie P, Jull G: Wireless orientation sensors: their suitability to measure head movement for neck pain assessment. Man Ther. 2007, 12 (4): 380-385. 10.1016/j.math.2006.07.005. doi:10.1016/j.math.2006.07.005CrossRefPubMed Jasiewicz JM, Treleaven J, Condie P, Jull G: Wireless orientation sensors: their suitability to measure head movement for neck pain assessment. Man Ther. 2007, 12 (4): 380-385. 10.1016/j.math.2006.07.005. doi:10.1016/j.math.2006.07.005CrossRefPubMed
19.
go back to reference Passier LN, Nasciemento MP, Gesch JM, Haines TP: Physiotherapist observation of head and neck alignment. Physiother Theory Pract. 2010, 26 (6): 416-423. 10.3109/09593980903317557. doi:10.3109/09593980903317557CrossRefPubMed Passier LN, Nasciemento MP, Gesch JM, Haines TP: Physiotherapist observation of head and neck alignment. Physiother Theory Pract. 2010, 26 (6): 416-423. 10.3109/09593980903317557. doi:10.3109/09593980903317557CrossRefPubMed
20.
go back to reference Enoch F, Kjaer P, Elkjaer A, Remvig L, Juul-Kristensen B: Inter-examiner reproducibility of tests for lumbar motor control. BMC Musculoskelet Disord. 2011, 12: 114-10.1186/1471-2474-12-114.CrossRefPubMedPubMedCentral Enoch F, Kjaer P, Elkjaer A, Remvig L, Juul-Kristensen B: Inter-examiner reproducibility of tests for lumbar motor control. BMC Musculoskelet Disord. 2011, 12: 114-10.1186/1471-2474-12-114.CrossRefPubMedPubMedCentral
21.
go back to reference Murphy DR, Byfield D, Mccarthy P, Humphreys K, Gregory AA, Rochon R: Inter-examiner reliability of the hip extension test for suspected inpaired motor control of the lumbar spine. J Manipulative Physiol Ther. 2006, 29 (5): 374-377. 10.1016/j.jmpt.2006.04.012.CrossRefPubMed Murphy DR, Byfield D, Mccarthy P, Humphreys K, Gregory AA, Rochon R: Inter-examiner reliability of the hip extension test for suspected inpaired motor control of the lumbar spine. J Manipulative Physiol Ther. 2006, 29 (5): 374-377. 10.1016/j.jmpt.2006.04.012.CrossRefPubMed
22.
go back to reference Vernon H: The neck disability index: state-of-the-art, 1991–2008. J Manipulative Physiol Ther 010. 31 (7): 491-502. doi:10.1016/j.jmpt.2008.08.006 Vernon H: The neck disability index: state-of-the-art, 1991–2008. J Manipulative Physiol Ther 010. 31 (7): 491-502. doi:10.1016/j.jmpt.2008.08.006
23.
go back to reference McDonnell MK, Sahrmann S: Movement - Impairment Syndromes of the Thoracic and Cervical Spine. Physical Therapy Of The Cervical And Thoracic Spine. Edited by: Grant R. 2002, Churchill Livingstone, 3 McDonnell MK, Sahrmann S: Movement - Impairment Syndromes of the Thoracic and Cervical Spine. Physical Therapy Of The Cervical And Thoracic Spine. Edited by: Grant R. 2002, Churchill Livingstone, 3
24.
go back to reference Sim J, Wright CC: The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther. 2005, 85 (3): 257-268.PubMed Sim J, Wright CC: The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther. 2005, 85 (3): 257-268.PubMed
25.
go back to reference Della Casa E, Affolter Helbling J, Meichtry A, Luomajoki H, Kool J: Head-Eye movement control tests in patients with chronic neck pain; inter-observer reliability and discriminative validity. BMC Musculoskelet Disord. 2014, 15: 16-10.1186/1471-2474-15-16.CrossRefPubMedPubMedCentral Della Casa E, Affolter Helbling J, Meichtry A, Luomajoki H, Kool J: Head-Eye movement control tests in patients with chronic neck pain; inter-observer reliability and discriminative validity. BMC Musculoskelet Disord. 2014, 15: 16-10.1186/1471-2474-15-16.CrossRefPubMedPubMedCentral
26.
go back to reference Jull G, Kristjansson E, Dall’Alba P: Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients. Man Ther. 2004, 9 (2): 89-94. 10.1016/S1356-689X(03)00086-9. doi:10.1016/S1356-689X(03)00086-9CrossRefPubMed Jull G, Kristjansson E, Dall’Alba P: Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients. Man Ther. 2004, 9 (2): 89-94. 10.1016/S1356-689X(03)00086-9. doi:10.1016/S1356-689X(03)00086-9CrossRefPubMed
27.
go back to reference O’Leary S, Jull G, Kim M, Vicenzino B: Cranio-cervical flexor muscle impairment at maximal, moderate, and low loads is a feature of neck pain. Man Ther. 2007, 12 (1): 34-39. 10.1016/j.math.2006.02.010. doi:10.1016/j.math.2006.02.010CrossRefPubMed O’Leary S, Jull G, Kim M, Vicenzino B: Cranio-cervical flexor muscle impairment at maximal, moderate, and low loads is a feature of neck pain. Man Ther. 2007, 12 (1): 34-39. 10.1016/j.math.2006.02.010. doi:10.1016/j.math.2006.02.010CrossRefPubMed
28.
go back to reference Uthaikhup S, Jull G: Performance in the cranio-cervical flexion test is altered in elderly subjects. Man Ther. 2009, 14 (5): 475-479. 10.1016/j.math.2008.12.003. doi:10.1016/j.math.2008.12.003CrossRefPubMed Uthaikhup S, Jull G: Performance in the cranio-cervical flexion test is altered in elderly subjects. Man Ther. 2009, 14 (5): 475-479. 10.1016/j.math.2008.12.003. doi:10.1016/j.math.2008.12.003CrossRefPubMed
29.
go back to reference Uthaikhup S, Sterling M, Jull G: Cervical musculoskeletal impairment is common in elders with headache. Man Ther. 2009, 14 (6): 636-641. 10.1016/j.math.2008.12.008. doi:10.1016/j.math.2008.12.008CrossRefPubMed Uthaikhup S, Sterling M, Jull G: Cervical musculoskeletal impairment is common in elders with headache. Man Ther. 2009, 14 (6): 636-641. 10.1016/j.math.2008.12.008. doi:10.1016/j.math.2008.12.008CrossRefPubMed
30.
go back to reference Zito G, Jull G, Story I: Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Man Ther. 2006, 11 (2): 118-129. 10.1016/j.math.2005.04.007. doi:10.1016/j.math.2005.04.007CrossRefPubMed Zito G, Jull G, Story I: Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Man Ther. 2006, 11 (2): 118-129. 10.1016/j.math.2005.04.007. doi:10.1016/j.math.2005.04.007CrossRefPubMed
31.
go back to reference Hoy DG, Protani M, De R, Buchbinder R: The epidemiology of neck pain. Best Pract Res Clin Rheumatol. 2010, 24 (6): 783-792. 10.1016/j.berh.2011.01.019. doi:10.1016/j.berh.2011.01.019CrossRefPubMed Hoy DG, Protani M, De R, Buchbinder R: The epidemiology of neck pain. Best Pract Res Clin Rheumatol. 2010, 24 (6): 783-792. 10.1016/j.berh.2011.01.019. doi:10.1016/j.berh.2011.01.019CrossRefPubMed
32.
go back to reference Côté P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, Disorders, B. a. J. D.-T. F. o. N. P. a. I: A: 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. Spine (Phila Pa 1976). 2008, 33 (4 Suppl): S60-S74. doi:10.1097/BRS.0b013e3181643ee4CrossRef Côté P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, Disorders, B. a. J. D.-T. F. o. N. P. a. I: A: 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. Spine (Phila Pa 1976). 2008, 33 (4 Suppl): S60-S74. doi:10.1097/BRS.0b013e3181643ee4CrossRef
33.
go back to reference Hogg-Johnson S, van der Velde G, Carroll LJ, Holm LW, Cassidy JD, Guzman J, Peloso P: 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 Manipulative Physiol Ther. 2009, 32 (2 Suppl): S46-S60. doi:10.1016/j.jmpt.2008.11.010CrossRefPubMed Hogg-Johnson S, van der Velde G, Carroll LJ, Holm LW, Cassidy JD, Guzman J, Peloso P: 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 Manipulative Physiol Ther. 2009, 32 (2 Suppl): S46-S60. doi:10.1016/j.jmpt.2008.11.010CrossRefPubMed
34.
go back to reference Manchikanti L, Singh V, Datta S, Cohen SP, Hirsch JA, Physicians AS. o. I. P: Comprehensive review of epidemiology, scope, and impact of spinal pain. Pain Physician. 2009, 12 (4): E35-E70.PubMed Manchikanti L, Singh V, Datta S, Cohen SP, Hirsch JA, Physicians AS. o. I. P: Comprehensive review of epidemiology, scope, and impact of spinal pain. Pain Physician. 2009, 12 (4): E35-E70.PubMed
Metadata
Title
Reliability of movement control tests on the cervical spine
Authors
Maja Patroncini
Susanne Hannig
André Meichtry
Hannu Luomajoki
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2014
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-15-402

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