Inter-examiner reliability to detect painful upper cervical joint dysfunction

Abstract

The presence of painful upper cervical joint dysfunction is a diagnostic criterion for cervicogenic headache. This preliminary study investigated whether independent examiners for a planned multicentre study of treatment of cervicogenic headache sufferers would agree on the presence or not of joint dysfunction for inclusion/exclusion of subjects into the trial. Ten subjects with or without neck pain and headache were recruited in each of four centres (total 40 subjects). Examiners manually assessed subjects' upper cervical regions in a single blind manner. There was excellent to complete agreement between each pair of examiners on which subjects should be allowed to enter the study and 70 per cent agreement between examiners on the two most dysfunctional joints in symptomatic subjects. There can be confidence that an homogenous headache group will enter the planned trial.

International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study

“…However, PPIVMs, combined cervical movements and impairments of the thoracic spine have never been published to differentiate between headache populations and headache free participants. Additionally, test properties such as inter-/intra-rater reliability, have only been previously assessed for manual joint palpation (Watson and Trott 1993;Jull et al 1997Jull et al , 2007Van Suijlekom et al 2000;Zito et al 2006;Hall et al 2010), the cranio-cervical M A N U S C R I P T…”

Upper Cervical and Upper Thoracic Thrust Manipulation Versus Nonthrust Mobilization in Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial

“…7,28,45,55,69,88,90 Nevertheless, the C1-2 articulation has been found to have a high frequency of symptomatic involvement in patients with neck pain and headaches. 41,42,54,100 Previous studies have demonstrated that 39° to 45° of the total cervical ROM occurs at the C1-2 articulation, 1,27,41,71,77 and that only 4° to 8° of rotation occurs at each motion segment from C2-3 to C6-7. 71 Furthermore, following upper cervical HVLA thrust manipulation, immediate and significant improvements in C1-2 rotation asymmetry have been demonstrated.…”

Long-Term Stability and Minimal Detectable Change of the Cervical Flexion-Rotation Test

“…14,16,25 However, these tests require a high level of clinical skill on the part of the therapist, and the reliability of these tests has been questioned. 29 The C1-C2 motion segment accounts for 50% of the rotation in the cervical spine.…”