J Manipulative Physiol Ther. 1997 Oct; 20(8): 516-20.

Interexaminer reliability in physical examination of the neck.

Strender LE, Lundin M, Nell K.

Department of Clinical Neuroscience and Family Medicine, Karolinska Institute, Stockholm, Sweden. lars-erik.strender@cnsf.ki.se

BACKGROUND: There are numerous clinical tests used in the evaluation of patients with symptoms arising from the cervical spine. It is necessary to use clinical tests with high validity and reliability. Previous studies of reliability of clinical tests used in the evaluation of the cervical spine have come to various conclusions, most of which suggest low reliability. This might be explained by differences between examiners in performance and where the limit of normality is placed. OBJECTIVE: To evaluate the interexaminer reliability of clinical tests used in everyday clinical work, where the examiners base their evaluations on a comparison between left and right sides. STUDY DESIGN: A total of 50 volunteers were examined by two physiotherapists. The interexaminer reliability of clinical tests included in the physical examination of patients with symptoms from the cervical spine was evaluated. METHODS: Two physiotherapists independently examined volunteers. RESULTS: An acceptable reliability was found for two of 10 clinical tests. CONCLUSION: When it is possible to compare left and right sides, it is possible to show acceptable reliability for some clinical tests. Reliability studies most often find low reliability, perhaps because of bias; clinical tests are not standardized. In future studies, greater efforts should be taken to reduce bias.