Reliability and validity of cervical position measurements in individuals with and without chronic neck pain

Abstract

Objectives: The cervical range of motion device (CROM) has been shown to provide reliable forward head position (FHP) measurement when the upper cervical angle (UCA) is controlled. However, measurement without UCA standardization is reflective of habitual patterns. Criterion validity has not been reported. The purposes of this study were to establish: (1) criterion validity of CROM FHP and UCA compared to Optotrak data, (2) relative reliability and minimal detectable change (MDC 95 ) in patients with and without cervical pain, and (3) to compare UCA and FHP in patients with and without pain in habitual postures. Methods: (1) Within-subjects single session concurrent criterion validity design. Simultaneous CROM and OP measurement was conducted in habitual sitting posture in 16 healthy young adults. (2) Reliability and MDC 95 of UCA and FHP were calculated from three trials. (3) Values for adults over 35 years with cervical pain and age-matched healthy controls were compared. Results: (1) Forward head position distances were moderately correlated and UCA angles were highly correlated. The mean (standard deviation) differences can be expected to vary between 1.48 cm (1.74) for FHP and 21.7 (2.46)u for UCA. (2) Reliability for CROM FHP measurements were good to excellent (no pain) and moderate (pain). Cervical range of motion FHP MDC 95 was moderately low (no pain), and moderate (pain). Reliability for CROM UCA measurements was excellent and MDC 95 low for both groups. There was no difference in FHP distances between the pain and no pain groups, UCA was significantly more extended in the pain group (P,0.05). Discussion: Cervical range of motion FHP measurements were only moderately correlated with Optotrak data, and limits of agreement (LOA) and MDC 95 were relatively large. There was also no difference in CROM FHP distance between older symptomatic and asymptomatic individuals. Cervical range of motion FHP measurement is therefore not recommended as a clinical outcome measure. Cervical range of motion UCA measurements showed good criterion validity, excellent test-retest reliability, and achievable MDC 95 in asymptomatic and symptomatic participants. Differences of more than 6u are required to exceed error. Cervical range of motion UCA shows promise as a useful reliable and valid measurement, particularly as patients with cervical pain exhibited significantly more extended angles.

Psychometric Proprieties of a Mobile Application to Measure the Craniovertebral Angle a Validation and Reliability Study

“…However, since reliability was not evaluated among inexperienced examiners, this cannot be conclusively affirmed, as in the study by Cheung et al [ 14 ]. However, despite the high levels of reliability, the reference point for the measurement of the CV angle represents a limitation, since it is subject-dependent and influenced by the palpation of spinous references, as indicated by Dunleavy et al [ 10 ].…”

“…In this posture, there is extension of the upper cervical vertebrae and flexion of the lower ones [ 9 ]. This poor alignment is associated with the increased use of electronic devices, among other causes, such as long periods of study in school-aged children or sedentary office work in adults [ 10 ].…”

Comparative effectiveness of Pilates and yoga group exercise interventions for chronic mechanical neck pain: quasi-randomised parallel controlled study

“…A c c e p t e d M a n u s c r i p t 8 postural measurements is moderate to excellent (ICC 2,1 0.69 to 0.94) [24]. Criterion validity compared with digital measurements is moderate to good (ICC 2,k 0.72-to 0.89) [23].…”

Precision and repeatability analysis of a motion analysis system for traction therapy

“…Neck pain or cervical pain is most common in individuals who are all working in seated postures including computer users [22][23][24][25][26]. The cervical pain caused by extreme postural positions including forward head postures and upper cervical extension angle [27][28][29].…”