Intra- and inter-rater reliability of neutral head position and target head position tests in patients with and without neck pain

Alahmari, Khalid A.; Samuel, Paul Silvian; Ahmad, Irshad; Nagaraj, Venkat; Mahtab, Mohammad

doi:10.1016/j.bjpt.2017.05.003

Cited by 50 publications

(51 citation statements)

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“…Encouragingly, similar inter-rater reliability values for error frequency (ICC = 0.93) were shown in the Australian study of asymptomatic controls who overall demonstrated less mean errors than the neck pain subjects in the current study [ 21 ]. Furthermore, intra-rater reliability shown in our study is comparably high to values reported for rating similar test procedures like joint position error (JPE) measurements [ 36 , 37 ]. In a study requiring head repositioning after neck rotation or flexion/extension returning to a neutral and target head position, similar ICCs and SEMS to our results were reported (intra: ICC between 0.70–0.83, SEM 1.45–2.45; inter: 0.62–0.84, SEM 1.50–2.23) [ 36 ].…”

Section: Discussionsupporting

confidence: 75%

“…Furthermore, intra-rater reliability shown in our study is comparably high to values reported for rating similar test procedures like joint position error (JPE) measurements [ 36 , 37 ]. In a study requiring head repositioning after neck rotation or flexion/extension returning to a neutral and target head position, similar ICCs and SEMS to our results were reported (intra: ICC between 0.70–0.83, SEM 1.45–2.45; inter: 0.62–0.84, SEM 1.50–2.23) [ 36 ]. Juul et al [ 37 ] reported lower ICCs but better SEMs in examining the reliability of rating JPE returning to a neutral head position from rotation, extension and flexion (intra: ICC 0.48–0.82, SEM 0.19–0.26; inter: ICC 0.50–0.75, SEM 0.20–0.50).…”

Section: Discussionsupporting

confidence: 75%

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Intra and interrater reliability and clinical feasibility of a simple measure of cervical movement sense in patients with neck pain

Werner

Ernst

Treleaven

et al. 2018

BMC Musculoskelet Disord

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BackgroundPattern tracing tasks can be used to assess cervical spine movement sense (CMS). A simple clinical measure of CMS (tracing fixed figure-of-eight (F8) and zigzag (ZZ) patterns with a head mounted laser) has been proposed and assessed in asymptomatic subjects. It is important to determine if examiner ratings of the traces are reliable and feasible for clinical use in those with neck pain. We therefore examined the intra- and inter-rater reliability of rating video recordings of the CMS tasks, and the feasibility of undertaking the tests in clinic by comparing slow motion versus real-time video ratings.MethodsCross-sectional study examining neck pain subjects from a physiotherapy clinic. F8 and ZZ patterns traced with a head-mounted laser pointer at two velocities (accurate; accurate & fast) were videoed and later examined. Time (total time taken to complete the pattern), error frequency (number of deviations) and error magnitude (sum of deviations multiplied by distance from the central line) were measured. Two assessors independently evaluated the laser tracing videos in slow motion; a third rated the videos in real time. Intraclass correlation coefficients (ICC) and standard error of measurements (SEM) were calculated for intra- and inter-tester reliability, and feasibility.ResultsTwenty neck pain patient (13 women) videos were assessed. Intra-and inter-rater reliability was substantial to almost-perfect (ICC 0.76–1.00; SEM < 0.01–2.50). Feasibility was moderate to almost-perfect (ICC 0.54–1; SEM < 0.01–2.98).ConclusionsVideo (slow motion) ratings of time and errors for F8 and ZZ movement patterns in neck pain subjects showed high intra and inter-rater reliability. Achieving reliable ratings in clinic (real-time) appears feasible. Synthesising our results, the most reliable and feasible CMS ratings appear to be when the subject uses accurate rather than accurate and fast execution. The ZZ movement pattern may be superior to F8 in terms of rating. Time and error frequency for tracing F8 and ZZ as accurately as possible in determining CMS appears promising for use in clinic. Future research directions were identified.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionsupporting

confidence: 75%

Intra and interrater reliability and clinical feasibility of a simple measure of cervical movement sense in patients with neck pain

Werner

Ernst

Treleaven

et al. 2018

BMC Musculoskelet Disord

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“…For measuring cervical JPE, this study adopted the active head repositioning to the target method, which several authors previously used in clinical settings and was found to be a reliable method [12,39]. The number of testing trials or movement repetitions in each direction was limited to three to minimize the effect of fatigue of cervical muscles on JPE.…”

Section: Discussionmentioning

confidence: 99%

“…We estimated cervical proprioception as cervical joint position errors in degrees, adapting the joint position errors testing protocol from Alahmari al. 's study [12]. Moreover, we estimated joint position errors following the subject's ability to actively reposition their head to a target position that the examiner previously demonstrated.…”

Section: Cervical Proprioceptionmentioning

confidence: 99%

The effect of Kinesio taping on cervical proprioception in athletes with mechanical neck pain—a placebo-controlled trial

Alahmari

Tedla

Samuel

et al. 2020

BMC Musculoskelet Disord

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Background Neck proprioception is critical in maintaining neuromuscular control in and around cervical joints. Kinesio™ tape may assist in rehabilitating joint position sense. The current study compares Kinesio™ tape’s effects versus a placebo on proprioception in college athletes experiencing mechanical neck pain. Methods This study randomized sixty-six athletes with mechanical neck pain into a Kinesio™ tape group (n = 33, mean age = 22.73 years) or placebo group (n = 33, mean age = 23.15 years). The Kinesio™ tape group received standard Kinesio™ taping applications with appropriate tension, while the placebo group received taping applications without tension. Outcome measures: The study assessed cervical joint position errors with a cervical range-of-motion (CROM) device, pain intensity with a visual analog scale (VAS), and neck functional disability with a neck disability index (NDI). It tested joint position errors through cervical flexion, extension, rotation left, and rotation right. All the outcome measures were recorded at the baseline and twice more following 3 and 7 days of tape applications. Results Multivariate analysis of variance test demonstrated a significant reduction in joint position errors in flexion, extension and right rotation following 3 days and 7 days of tape application among the Kinesio™ tape group. There was a significant main effect of time (P < 0.05) for joint position errors in left rotation and VAS after 3 days (p > 0.05), NDI after 3 and 7 days (p > 0.05). Conclusions The Kinesio™ tape application after 3 and 7 days effectively decreased joint position errors and neck pain intensity in mechanical neck pain participants compared to placebo, while there was no difference between both groups in the NDI. Trial registration (CTRI/2011/07/001925). This study was retrospectively registered on the 27th July, 2011. Level of evidence IIB

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“…Neutral head position method was used to evaluate proprioception in flexion, extension, rotation and lateral flexion in right and left movement directions at sitting position (figure 1). 5 Three measures were performed, and the average of the three trials was used for analysis. The distance between zero spot and joint position which patient had been reconstructed was measured by centimetre.…”

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confidence: 99%

AB1467-HPR Measurement of cervical proprioception in patients with axial spondyloarthritis

Özen

Tonga

Polat

et al. 2018

Saturday, 16 JUNE 2018

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BackgroundAxial spinal inflammation and spinal posture disorders in axial spondyloarthritis (axSpA) may deteriorate proprioception which may be caused by pathologic involvement of spinal entheses containing proprioceptive afferents.1 Cervical spine is one of the main inflammation area in axSpA.2 Impaired cervical proprioception has negative effects on postural control system.3 The cervicocephalic relocation mesure by laser pointer is found a reliable method to measure cervical sensory function in healty participants in a recent study.4 And there is limited data that regarding cervical proprioception in axSpA.ObjectivesTo examine the differences in cervical joint proprioception between patiens with axSpA and healthy subjects.MethodsThe cervical joint position errors (JPE) were measured to evaluate proprioceptive function accuracy in patients with 29 axSpA and 21 healthy subjects by laser pointer with cervical application. Neutral head position method was used to evaluate proprioception in flexion, extension, rotation and lateral flexion in right and left movement directions at sitting position (figure 1).5 Three measures were performed, and the average of the three trials was used for analysis. The distance between zero spot and joint position which patient had been reconstructed was measured by centimetre. Spinal mobility evaluated by BASMI, function evaluated by BASFI and HAQ-S; disease activity defined by BASDAI, pain and fatigue were evaluated by VAS.Abstract AB1467HPR – Figure 1ResultsThere were 29 patients (21 men, mean (±SD) age; 41.4±10.9 years) and 21 healthy subjects (15 men, mean age 41.1±11.3 years). BASMI, HAQ-S and fatigue score were significantly higher in patients (BASMI values were 3.9±2.3 vs 1.3±0.7, p<0.001; HAQ-S values were 2.1±0.8 vs 0.8±0.2, p<0.001; fatigue values were 37.2±23.3 vs 16.2±14.9, p=0.001). The comparison of cervical JPE showed significantly larger errors (p<0.05) in patients with axSpa, except right rotation (p=0.166) (table 1).Abstract AB1467HPR – Table 1Comparison of joint position errors between patients with axSpa and healthy subjects Variable(cm)AxSpA patients(n=29)(mean±SD)Healthy subjects (n=21)(mean±SD)P value JPE in flexion9.88±6.704.66±3.570.001JPE in extension12.99±8.995.55±2.980.001JPE in right rotation11.10±6.568.62±4.410.166JPE in left rotation10.59±6.517.02±5.780.011JPE in right side bend11.32±6.536.39±3.540.001JPE in left side bend9.62±6.186.14±4.460.036JPE=Joint position error, p values are based on Mann-Whitney U test.ConclusionsCervical joint position sense is impaired in subjects with axSpa. Proprioceptive training may help to boost the effectiveness of rehabilitation.References[1] Pompeu JE, Romano RS, Pompeu SM, Lima SM. Revista brasileira de reumatologia. 2012;52(3):409–16.[2] Madsen OR. Rheumatol Int. 2018. doi: 10.1007/s00296–017–3920–1.[3] Malmström EM, Fransson PA, Jaxmar Bruinen T, Facic S, Tjernström F. Exp Brain Res. 2017;235(9):2755–2766.[4] Hatamvand S, Ghiasi F, Asgari Ashtiani A.R, Akbari A, Hossienifar M. International Journal of Medical Resear...

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Intra- and inter-rater reliability of neutral head position and target head position tests in patients with and without neck pain

Abstract: Highlights•Neutral head and target head position tests evaluate cervical proprioception.•Clinics commonly use those position tests, and it is important to test their reliability.•Intra- and inter-rater reliability was moderate to high for these tests.

Cited by 50 publications

References 46 publications

Intra and interrater reliability and clinical feasibility of a simple measure of cervical movement sense in patients with neck pain

Intra and interrater reliability and clinical feasibility of a simple measure of cervical movement sense in patients with neck pain

The effect of Kinesio taping on cervical proprioception in athletes with mechanical neck pain—a placebo-controlled trial

AB1467-HPR Measurement of cervical proprioception in patients with axial spondyloarthritis

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