title: Intrarater and interrater reliability of select clinical tests in patients referred for diagnostic facet joint blocks in the cervical spine.
abstract: OBJECTIVE
  To measure the intra- and interrater reliability of select standardized clinical tests used for the assessment of patients with axial neck pain referred for diagnostic facet joint blocks.
  
  
  METHODS
  Single-group, repeated-measures study.
  
  
  METHODS
  Tertiary interventional pain management center.
  
  
  METHODS
  Consecutive patients with persistent neck pain, referred to a tertiary interventional pain management center, were approached to participate. Fifty-six patients consented to participate in the study.
  
  
  METHODS
  Subjects underwent a standardized clinical testing protocol, performed by 2 physiotherapists, before receiving diagnostic facet joint blocks. Subjects were examined twice by 1 assessor for the determination of the intrarater reliability of the testing protocol, and again by a second assessor for determination of interrater reliability.
  
  
  METHODS
  Intraclass correlation coefficients (ICCs), kappa coefficients, and 95% confidence intervals were calculated to determine the intra- and interrater reliability for cervical range of motion (ROM; 6 directions), extension-rotation (ER) test, manual spinal examination (MSE), and palpation for paraspinal tenderness (PST) from C2 through C7.
  
  
  RESULTS
  For intrarater reliability, kappa coefficients ranged from .51 to .88 for the ER test, MSE, and PST, and ICCs ranged from .91 to .97 for ROM. For interrater reliability, kappa coefficients ranged from .74 to .96 for the ER test, MSE, and PST, and ICCs ranged from .90 to .95 for ROM.
  
  
  CONCLUSIONS
  The standardized clinical tests exhibited moderate to substantial reliability in patients with axial neck pain referred for diagnostic facet joint blocks. The data justify the incorporation of these tests into a clinical prediction model to screen patients before referral for diagnostic facet blocks.
authors.affiliation: Graduate Sciences Education, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. gmschnei@ucalgary.ca
authors.forename: Geoff M
authors.initials: GM
authors.lastname: Schneider
authors.forename: Gwendolen
authors.initials: G
authors.lastname: Jull
authors.forename: Kenneth
authors.initials: K
authors.lastname: Thomas
authors.forename: Ashley
authors.initials: A
authors.lastname: Smith
authors.forename: Carolyn
authors.initials: C
authors.lastname: Emery
authors.forename: Peter
authors.initials: P
authors.lastname: Faris
authors.forename: Kathryn
authors.initials: K
authors.lastname: Schneider
authors.forename: Paul
authors.initials: P
authors.lastname: Salo
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D010173:Palpation; D018579:Patient Selection; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular / Q000502:physiology*; D015203:Reproducibility of Results; D055815:Young Adult; D021801:Zygapophyseal Joint
keywords: ER; Facet joint; ICC; MSE; NPRS; Neck; Neck pain; PST; Physical examination; ROM; Rehabilitation; Reliability (epidemiology); SEM; extension-rotation; intraclass correlation coefficient; manual spinal examination; numeric pain rating scale; palpation for segmental tenderness; range of motion; standard error of measurement