J Manipulative Physiol Ther. 1995 Jun; 18(5): 293-7.

Measuring passive cervical motion: a study of reliability.

Nilsson N.

Nordic Institute of Chiropractic, Odense, Denmark.

PURPOSE: To study the inter- and intraexaminer reliability of assessing passive cervical range of motion. DESIGN: Blind, repeated measures of passive cervical range of motion by two different examiners. SETTING: Ambulatory outpatient facility in an independent NHS funded chiropractic research institution. PARTICIPANTS: Fourteen asymptomatic volunteers, 7 men and 7 women, aged 23-45 years. INTERVENTION: Measurement of passive cervical range of motion using a strap-on head goniometer by two blinded examiners. Each subject was measured three times with 20-min intervals between each measurement, using a mean-of-five-measurements protocol. MAIN OUTCOME MEASURE: Passive cervical range of motion in 6 separate directions of movement from "neutral zero"--right and left lateral flexion, right and left rotation and flexion and extension. RESULTS: The inter- and intraexaminer reliability was evaluated using a paired t test and Pearson's Correlation Coefficient (supplemented by a scatterplot). Intraexaminer reliability was found to be acceptable (Pearson's r = 0.61-0.86), whereas interexaminer reliability was less than acceptable (Pearson's r = 0.29-0.66). CONCLUSION: Passive cervical range of motion could be measured reliably on different occasions by the same examiner but not by different examiners. It is unclear whether low interexaminer reliability in the present study was because of inherent methodological problems or because of insufficient training of examiners before the study.