J Manipulative Physiol Ther. 1995 Feb; 18(2): 88-90.

Measuring cervical muscle tenderness: a study of reliability.

Nilsson N.

Nordic Institute of Chiropractic, Odense, Denmark.

PURPOSE: To study the inter- and intraexaminer reliability of assessing palpatory cervical muscle tenderness using a Total Tenderness Score System. DESIGN: Blinded, repeated measures of cervical muscle Total Tenderness Score. SETTING: Primary contact ambulatory outpatient facility in a publicly (National Health Service) funded chiropractic research institution. PARTICIPANTS: Fourteen asymptomatic volunteers, seven male and seven female, aged 23-45 yr. INTERVENTION: Palpatory assessment of cervical muscle tenderness by two blinded examiners, three times in all per subject. MAIN OUTCOME MEASURES: Total Tenderness Score (TTS), measured on a rank/ordinal scale. RESULTS: The inter- and intraexaminer reliability of TTS was evaluated using a Spearman rank correlation coefficient (r = .88 and r = .85, respectively), and using a Wilcoxon paired rank sum test (p = .85 and p = .07, respectively) and by visual inspection of a scatter-plot. CONCLUSION: The Total Tenderness Score system was deemed to possess acceptable reliability for use in the cervical muscles.