Reproducibility of Active and Passive ROM in Neck Pain Patients

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Reproducibility of Active and Passive ROM in Neck Pain Patients

Heightened interest in the effectiveness of chiropractic and other methods in treating neck pain has resulted in a need for reproducible methods of physical examination in neck pain patients. However, relatively few studies examining the validity and reproducibility of physical examination procedures in patients with neck pain have been conducted.

Even less is known about whether a practitioner's knowledge of a patient's history may influence the reliability of such procedures or the prevalence of positive findings.
The purpose of this study was to assess the reproducibility of tests for active and passive range of motion used in the physical examination of patients with neck pain. In the study, two physiotherapy students examined 69 patients divided into three groups. Two groups included patients with a history of neck pain, but in only one group was that information made known to the students prior to the physical exam. The examination consisted of six active and six passive movements (flexion, extension, left and right rotation, and left and right lateral flexion) designed to examine the range of movement of the cervical spine. Every movement was performed twice by each examiner and classified as normal or restricted. Physical examinations were performed in a random sequence, and the examiners did not report their findings to the patients to prevent the passing of information between examiners.
The percentage of agreement for all active and passive range of motions between the two examiners was 78.2 percent. Extension of the neck showed good reproducibility for both active and passive movements, whereas lateral flexion showed poor reproducibility. Results also showed that the examiners' knowledge of patient history had no influence on the reproducibility of movements and had "no apparent difference" in the percentage of positive findings.
Hoppenbrouwers M, Eckhardt MMEM, Verkerk K, Verhagen A. Reproducibility of the measurement of active and passive cervical range of motion. Journal of Manipulative and Physiological Therapeutics 2006;29(5):363-67.