Intrarater Reliability of CROM Measurement of Cervical Spine Active Range of Motion in Persons With and Without Neck Pain

STUDY DESIGN: Clinical measurement, intrarater reliability study. OBJECTIVES: To determine the intrarater reliability of cervical active range of motion (AROM) measurement of subjects with and without neck pain using the cervical range-of-motion device (CROM). BACKGROUND: Cervical spine AROM data are used by physical therapists to assist in identifying movement impairment, monitor patient progress, and evaluate the effectiveness of intervention. Presently, insufficient literature exists regarding the intrarater reliability of cervical AROM measurements using the CROM. METHODS AND MEASURES: Twenty-five adult subjects without neck pain and 22 adult subjects with neck pain volunteered for the study. Two trials of cervical AROM measurement (6 movements) were performed for each subject. Practice sessions, methods of measurement, and rest time between trials were standardized; order of measurement was randomized. RESULTS: The intraclass correlation coefficients (ICC3.1) for the subjects without neck pain ranged from 0.87 for flexion (95% confidence interval [Cl]: 0.76-0.95) to 0.94 for left rotation (95% Cl: 0.87-0.97). The standard error of the measurement ranged from 2.3 degrees to 4,0 degrees, The ICCs for the subjects with neck pain ranged from 0.88 for flexion (95% Cl: 0.73-0.95) to 0.96 for left rotation (95% Cl: 0.91-0.98). The standard error of the measurement ranged from 2.5 degrees to 4.1 degrees. Minimal detectable change ranged from 5.4 degrees for left rotation in the subjects without neck pain to 9.6 degrees for flexion in the subjects with neck pain. CONCLUSION: Intrarater reliability for cervical AROM measurement of persons with and without neck pain is sufficient to consider use of the CROM in clinical practice, although changes between 5 degrees to 10 degrees are needed to feel confident that a real change in spine mobility has occurred. J Orthop Sports Phys Ther 2008;38(10):640-645. doi:10.2519/jospt.2008.2680