Intra and Inter-Rater Reliability for Deep Neck Flexor and Neck Extensor Muscle Endurance Tests in Subjects with and without Subclinical Neck Pain

Abstract

Purpose Deep neck flexor (DNF) and neck extensor (NE) muscle endurance tests are a part of standard assessment procedure in routine physical therapy practice and these tests needs to be reliable.

Materials and Methods Intra-rater (between-day) and inter-rater (within-day) reliability was assessed for 2 neck muscle endurance tests in 26 subclinical neck pain and 31 normal subjects by 2 blinded assessors. The tests conducted included 1) DNF endurance test performed in supine and 2) NE muscle endurance test performed in prone position.

Results and discussion The Intra-rater and inter-rater reliability was determined by means of Intra Class Correlation (ICC), with 95% confidence intervals. The intra rater reliability testing showed good agreement for both DNF (ICC=0.76 and 0.78) and NE muscle endurance (ICC=0.75 and 0.76) tests. Meanwhile, the inter-rater reliability showed moderate to good agreement for both DNF (ICC – 0.58 and 0.61) and NE muscle endurance tests (ICC – 0.57 and 0.74) in subjects with subclinical neck pain. Subclinical neck pain subjects had a significantly lower endurance holding times compared to normal (p<0.001).

Conclusion The intra and inter rater reliability ranged from moderate to good agreement. Neck flexor and extensor muscle endurance can be measured reliably in a clinical setup in subjects with subclinical neck pain.

Zusammenfassung

Ziel Ausdauertests der tiefen zervikalen Flexoren und der zervikalen Extensoren gehören zu den Standarduntersuchungen in physiotherapeutischen Praxen und die Reliabilität solcher Tests ist von entscheidender Bedeutung.

Material und Methoden Es wurde die Intrarater- (an unterschiedlichen Tagen) – und Interrater- (innerhalb eines Tages) Reliabilität von 2 Ausdauertests der zervikalen Muskulatur untersucht. Für die Studie wurden 26 Patienten mit subklinischen Nackenschmerzen und 31 schmerzfreie Patienten von 2 verblindeten Untersuchern bewertet. Es wurden 1) ein Ausdauertest der tiefen zervikalen Flexoren in Rückenlage und 2) ein Ausdauertest der zervikalen Extensoren in Bauchlage durchgeführt.

Ergebnisse und Diskussion Die Intra- und Interrater-Reliabilität wurde mittels Intra-Klassen-Korrelation bestimmt, mit einem 95%-Konfidenzintervall. Die Messung der Intrarater-Reliabilität zeigte sowohl für die Ausdauertests der tiefen zervikalen Flexoren (ICC=0,76 und 0,78) als auch für die Tests der zervikalen Extensoren (ICC=0,75 und 0,76) eine gute Übereinstimmung. Die Messung der Interrater-Reliabilität zeigte dagegen moderate bis gute Übereinstimmung sowohl bei den Tests der tiefen zervikalen Flexoren (ICC – 0.58 und 0.61) als auch bei den Tests der zervikalen Extensoren (ICC – 0,57 und 0,74) bei Teilnehmern mit subklinischen Nackenschmerzen. Im Vergleich zu den schmerzfreien Teilnehmern erzielten Teilnehmer mit subklinischen Nackenschmerzen signifikant niedrigere Ausdauerwerte (p<0,001).

Schlussfolgerung Die Intra- und Interrater-Reliabilität reichte von moderate bis gute Übereinstimmung. Die Ausdauer der zervikalen Flexoren und der Extensoren kann bei Patienten mit subklinischen Nackenschmerzen in einem klinischen Setting zuverlässig gemessen werden.

Key words

Neck Pain - Physical Endurance - Assessment tools - Reproducibility of Results

Schlüsselwörter

Nackenschmerzen - Körperliche Ausdauer - Bewertungsinstrumente - Reproduzierbarkeit der Ergebnisse

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