Cervical nonorganic signs: a new clinical tool to assess abnormal illness behavior in neck pain patients: a pilot study.
OBJECTIVE
To develop and assess the reliability of a group of cervical nonorganic physical signs to be used as a simple screening tool for identifying patients with low neck pain who exhibit abnormal illness behavior.


METHODS
Survey, consecutive sample.


METHODS
Double masked.


METHODS
Functional restoration program.


METHODS
Twenty-six consecutive patients with complaints of chronic neck pain (greater than 4 months duration). Each patient was evaluated by a physician and then again by either a physical or occupational therapist, for the presence of specific cervical nonorganic signs. Both of the evaluations occurred on the same day.


METHODS
Five categories consisting of eight tests were appraised: (1) tenderness, (2) simulation, (3) range of motion, (4) regional disturbance, and (5) overreaction.


RESULTS
The percent agreement between raters ranged from a high of 100% for regional sensory disturbance, to a low of 68% for one of the simulation tests. The average agreement between raters across all of the nonorganic test signs was 84.6%. Likewise, kappa coefficients ranged from 1.00 to .16, reflecting differences in strength of agreement.


CONCLUSIONS
For many years, the lumbar nonorganic signs (developed by Waddell and colleagues) have been a useful screening tool in the assessment of abnormal illness behavior in the low back pain population. For the first time, a group of cervical nonorganic signs have been developed, standardized, and proven reliable.
Sobel
J B
JB
Productive Rehabilitation Institute of Dallas for Ergonomics Research Foundation, TX, USA.
Sollenberger
P
P
Robinson
R
R
Polatin
P B
PB
Gatchel
R J
RJ
D000328:Adult; D002908:Chronic Disease; D004185:Disability Evaluation; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D010147:Pain Measurement; D010808:Physical Examination / Q000379:methods; D010865:Pilot Projects; D011602:Psychophysiologic Disorders / Q000175:diagnosis*; D015203:Reproducibility of Results; D012803:Sick Role