title: Validity and reliability of the aneroid sphygmomanometer using a paediatric size cuff for craniocervical flexion test.
abstract: BACKGROUND
  The craniocervical flexion test (CCFT) is generally undertaken using a pressure biofeedback unit. However, the high costs of the device limits its availability in poorly resourced healthcare settings. The use of alternate measures such as the aneroid sphygmomanometer to undertake CCFT need to be investigated.
  
  
  OBJECTIVE
  The objective of this study was to establish the concurrent validity, intra- and inter-rater reliability of the aneroid sphygmomanometer using a paediatric size cuff for CCFT in asymptomatic adults.
  
  
  METHODS
  This cross-sectional observational study involved 300 asymptomatic participants randomly allocated to either validity (n = 100), intra-rater (n = 100) or inter-rater (n = 100) testing. Participants were asked to perform CCFT to assess craniocervical flexors performance using the pressure biofeedback unit and the aneroid sphygmomanometer with a paediatric cuff. Inter-rater reliability test was performed by two different raters on the same day with rest of 30 min between tests. An independent observer checked and recorded the pressures noted on the pressure dial thus ensuring blinded outcome measurement. Correlation between the two instruments was determined by computing the stability coefficient (Pearson product moment correlation) and associated P-values for statistical significance. Intra-class correlation coefficients and its 95% confidence intervals (CIs) were calculated to determine the intra- and inter-rater reliability.
  
  
  RESULTS
  The concurrent validity of aneroid sphygmomanometer as per Pearson's product moment correlation was r = 0.856 for activation score. The intra-class correlation coefficients for intra-rater reliability was 0.92 (95% CI 0.89-0.94), and inter-rater reliability was 0.87 (95% CI 0.80-0.91).
  
  
  CONCLUSIONS
  This study has confirmed high concurrent validity, intra- and inter-rater reliability of the aneroid sphygmomanometer using a paediatric cuff for CCFT in asymptomatic adults. Its use in people with neck pain warrants investigation.
authors.affiliation: Seawoods Hospital, Navi Mumbai, Maharashtra, India.
authors.forename: Renu
authors.initials: R
authors.lastname: Mahashabde
authors.forename: Ritin
authors.initials: R
authors.lastname: Fernandez
authors.forename: Shaila
authors.initials: S
authors.lastname: Sabnis
mesh_terms: D000328:Adult; D001676:Biofeedback, Psychology / Q000295:instrumentation*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D009334:Neck Muscles / Q000503:physiopathology*; D015588:Observer Variation; D026741:Physical Therapy Modalities; D011897:Random Allocation; D019722:Sphygmomanometers
keywords: aneroid sphygmomanometer; craniocervical flexion test; pressure biofeedback; research; research methodology