title: Interrater reliability of the craniocervical flexion test in asymptomatic individuals--a cross-sectional study.
abstract: OBJECTIVE
  The objective of this study was to evaluate interrater reliability of the craniocervical flexion test (CCFT) on asymptomatic subjects.
  
  
  METHODS
  A cross-sectional repeated-measures study design was used. Thirty asymptomatic subjects (15 men and 15 women; mean age, 33.7 years; range, 22-48 years) were recruited for the study. Subjects were positioned in supine lying with a pneumatic pressure sensor of the pressure biofeedback unit placed under the neck. Subjects performed 3 trials of craniocervical flexion with each trial consisting of 5 incremental stages (22, 24, 26, 28, and 30 mm Hg) guided through feedback from the pressure dial of the pressure biofeedback unit. All the trials were scored simultaneously by 2 raters. The outcome measure was the activation score-the maximum pressure (above baseline 20 mm Hg) that was achieved and held in a steady manner for 10 seconds. Intraclass correlation coefficient (ICC 3,1) was analyzed using the 2 repeated scores out of 3 trials for either rater.
  
  
  RESULTS
  Interrater reliability (ICC) for the CCFT was 0.91 (95% confidence interval, 0.83-0.96). There was a reasonable agreement on the Bland-Altman plot confirming high reliability of the test.
  
  
  CONCLUSIONS
  The study has shown high interrater reliability when 2 raters simultaneously scored the CCFT trials in asymptomatic individuals.
authors.affiliation: Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand. aruas177@student.otago.ac.nz8
authors.forename: Ashokan
authors.initials: A
authors.lastname: Arumugam
authors.forename: Ramakrishnan
authors.initials: R
authors.lastname: Mani
authors.forename: Kavitha
authors.initials: K
authors.lastname: Raja
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000502:physiology*; D015588:Observer Variation; D010808:Physical Examination / Q000379:methods* / Q000706:statistics & numerical data*; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D055815:Young Adult