title: Reliability and group differences in quantitative cervicothoracic measures among individuals with and without chronic neck pain.
abstract: BACKGROUND
  Clinicians frequently rely on subjective categorization of impairments in mobility, strength, and endurance for clinical decision-making; however, these assessments are often unreliable and lack sensitivity to change. The objective of this study was to determine the inter-rater reliability, minimum detectable change (MDC), and group differences in quantitative cervicothoracic measures for individuals with and without chronic neck pain (NP).
  
  
  METHODS
  Nineteen individuals with NP and 20 healthy controls participated in this case control study. Two physical therapists performed a 30-minute examination on separate days. A handheld dynamometer, gravity inclinometer, ruler, and stopwatch were used to quantify cervical range of motion (ROM), cervical muscle strength and endurance, and scapulothoracic muscle length and strength, respectively.
  
  
  RESULTS
  Intraclass correlation coefficients for inter-rater reliability were significantly greater than zero for most impairment measures, with point estimates ranging from 0.45 to 0.93. The NP group exhibited reduced cervical ROM (P ≤ 0.012) and muscle strength (P ≤ 0.038) in most movement directions, reduced cervical extensor endurance (P = 0.029), and reduced rhomboid and middle trapezius muscle strength (P ≤ 0.049).
  
  
  CONCLUSIONS
  Results demonstrate the feasibility of obtaining objective cervicothoracic impairment measures with acceptable inter-rater agreement across time. The clinical utility of these measures is supported by evidence of impaired mobility, strength, and endurance among patients with NP, with corresponding MDC values that can help establish benchmarks for clinically significant change.
authors.affiliation: Physical Therapy Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Bahar
authors.initials: B
authors.lastname: Shahidi
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Johnson
authors.forename: Douglas
authors.initials: D
authors.lastname: Curran-Everett
authors.forename: Katrina S
authors.initials: KS
authors.lastname: Maluf
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000503:physiopathology*; D059350:Chronic Pain / Q000175:diagnosis* / Q000503:physiopathology; D003661:Decision Support Techniques; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007537:Isometric Contraction; D008297:Male; D053580:Muscle Strength; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000503:physiopathology*; D019547:Neck Pain / Q000175:diagnosis* / Q000503:physiopathology; D015588:Observer Variation; D010147:Pain Measurement; D010807:Physical Endurance; D010808:Physical Examination / Q000295:instrumentation; D011237:Predictive Value of Tests; D011379:Prognosis; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D013904:Thoracic Vertebrae / Q000503:physiopathology*; D055815:Young Adult