Systematic review of the diagnostic accuracy, reliability, and safety of the sharp-purser test

Mansfield, Cody J; Domnisch, Charlie; Iglar, Laura; Boucher, Laura C.; Oñate, James A.; Briggs, Matthew S.

doi:10.1080/10669817.2019.1667045

Cited by 10 publications

(10 citation statements)

References 36 publications

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“…This helps to maintain the position of the odontoid process on atlas (Reiley et al, 2017). Many clinicians use the test to identify C1-C2 instability prior to the manipulation, joint mobilization, or dry needling of the upper cervical spine (Mansfield et al, 2020). The patient is seated with slightly flexed head position.…”

Section: Sharp-purser Testmentioning

confidence: 99%

Upper cervical spine dysfunction and dizziness

Sung¹

2020

J Exerc Rehabil

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Although various causes of dizziness have been identified, many patients suffer from dizziness of unknown etiology and continue to visit hospitals to resolve their symptoms. Problems that occur in the ligaments or muscles of the upper cervical spine can cause confusion in proprioception. These changes can convey misinformation to the vestibular nucleus, resulting in abnormal reactions that can lead to cervicogenic dizziness (CGD). Though CGD remains controversial, it should be considered while diagnosing patients with dizziness. Understanding CGD can help create treatment strategies for them. This article suggested a relationship between the structure and function of the upper cervical spine and dizziness, and presented evaluations and treatments for the same.

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Section: Sharp-purser Testmentioning

confidence: 99%

Upper cervical spine dysfunction and dizziness

Sung¹

2020

J Exerc Rehabil

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“…To screen for upper cervical instability we performed the sharp purser test [25], test of the transverse ligament [26] and a stress test of the alar ligament [27]. Additionally, all subjects performed the FRT actively in sitting before testing.…”

Section: Questionnaires and Assessmentsmentioning

confidence: 99%

Concurrent validity and reliability of measuring range of motion during the cervical flexion rotation test with a novel digital goniometer

Luedtke

Schoettker-Königer

Hall

et al. 2020

BMC Musculoskelet Disord

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Background Headache is a common and costly health problem. Although the pathogenesis of headache is heterogeneous, reported contributing factors are dysfunctions of the upper cervical spine. The flexion rotation test (FRT) is a commonly used diagnostic test to detect upper cervical movement impairment. A digital goniometer may support precise measurement of movement impairment in the upper cervical spine. However, its reliability and validity is not assessed, yet. The aim of this study was to investigate the reliability and validity of the digital goniometer compared to an ultrasound-based movement analysis system. Methods Two separate cross-sectional studies were conducted using the digital goniometer EasyAngle (Meloq AB, Stockholm, Sweden) for a) investigating the concurrent validity of upper cervical range of motion (ROM) during the FRT and b) determining the inter- and intra-rater reliability in the target population of patients with head and neck pain. Sixty-two participants, 39 with and 23 without head and neck pain, were recruited for the concurrent validity study. For the reliability study, a total of 50 participants were recruited. Intraclass correlation coefficients (ICC) and Bland Altmann plots were used to assess validity and ICC values, Bland Altmann plots as well as Kappa coefficients were used for estimating intra-rater and inter-rater reliability. Results Concurrent validity was strong with an ICC (2,1) of 0.97 for ROM to either side (95%CI = 0.95–0.98). Bland Altman Plots revealed a mean difference between measurement systems of 0.5° for the left and 0.11° for the right side. The inter-rater ICC (2,1) was 0.66 (95%CI 0.47–0.79, p < 0.001, SEM 6.6°), indicating good reliability. The limits of agreement were between 10.25° and − 11.89°, the mean difference between both raters was − 0.82°. Intra-rater reliability for the measurement of ROM during the FRT was between 0.96 (ICC 3,1) for rater 1 and 0.94 (ICC 3,1) for rater 2. Conclusions The digital goniometer demonstrated strong concurrent validity and good to strong reliability and can be used in clinical practice to accurately determine movement impairment in the upper cervical spine. Trial registration German Registry of Clinical Trials DRKS00013051.

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“… Sharp Purser Test [ 13 , 14 ] Flexion Rotation Test [ 13 , 15 ] C2 Spinous Kick Test [ 13 ]. Modified Lateral Shear Test [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

Inter-examinerreliability study of physical examination procedures to assess the cervical spine

et al. 2021

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Objective The objective of this study was to establish the level of inter-examiner reliability for six common cervical manual and physical examination procedures used to assess the cervical spine. Materials: Reliability study that used a convenience sample of 51 patients between the ages of 16–70 years presenting with a chief complaint of neck pain. Two physical therapists independently performed the same series of cervical physical examination procedures on each of the participant. The clinicians were blinded to each other’s findings and the clinical status of the patient. Kappa coefficients (κ) were calculated for levels of agreement between the clinicians for each procedure. Results When assessing for asymmetrical motion, excellent levels of reliability (κ range: 0.88–0.96) were observed for the Bilateral Modified Lateral Shear (asymmetry criterion), Bilateral C2 Spinous Kick (asymmetry criterion) and Flexion-Rotation Tests. When pain provocation was used as the indicator of a positive test during palpation of the cervical facet joints, moderate to substantial levels of reliability (κ range: 0.53–0.76) were observed. When patients were instructed not to provide feedback to the clinicians about pain provocation during facet joint palpation and clinicians relied solely on their qualitative assessment of segmental mobility, the level of reliability was lower (κ range: 0.45–0.53). Due to 100 % prevalence of negative findings, Kappa values could not be calculated for the Sharp-Purser test or the Unilateral C2 Spinous Kick Test. Conclusions Most physical examination procedures examined in this study demonstrated moderate to excellent levels of inter-examiner reliability. Palpation for segmental mobility without pain provocation demonstrated a lower level of reliability compared to palpation for pain provocation. Correlation with clinical findings is necessary to establish validity and the applicability of these procedures in clinical practice.

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Systematic review of the diagnostic accuracy, reliability, and safety of the sharp-purser test

Cited by 10 publications

References 36 publications

Upper cervical spine dysfunction and dizziness

Upper cervical spine dysfunction and dizziness

Concurrent validity and reliability of measuring range of motion during the cervical flexion rotation test with a novel digital goniometer

Inter-examinerreliability study of physical examination procedures to assess the cervical spine

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