• Arch Phys Med Rehabil · Aug 2013

    Clinical Trial

    Intrarater and interrater reliability of select clinical tests in patients referred for diagnostic facet joint blocks in the cervical spine.

    • Geoff M Schneider, Gwendolen Jull, Kenneth Thomas, Ashley Smith, Carolyn Emery, Peter Faris, Kathryn Schneider, and Paul Salo.
    • Graduate Sciences Education, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. gmschnei@ucalgary.ca
    • Arch Phys Med Rehabil. 2013 Aug 1;94(8):1628-34.

    ObjectiveTo measure the intra- and interrater reliability of select standardized clinical tests used for the assessment of patients with axial neck pain referred for diagnostic facet joint blocks.DesignSingle-group, repeated-measures study.SettingTertiary interventional pain management center.ParticipantsConsecutive patients with persistent neck pain, referred to a tertiary interventional pain management center, were approached to participate. Fifty-six patients consented to participate in the study.InterventionsSubjects underwent a standardized clinical testing protocol, performed by 2 physiotherapists, before receiving diagnostic facet joint blocks. Subjects were examined twice by 1 assessor for the determination of the intrarater reliability of the testing protocol, and again by a second assessor for determination of interrater reliability.Main Outcome MeasuresIntraclass correlation coefficients (ICCs), kappa coefficients, and 95% confidence intervals were calculated to determine the intra- and interrater reliability for cervical range of motion (ROM; 6 directions), extension-rotation (ER) test, manual spinal examination (MSE), and palpation for paraspinal tenderness (PST) from C2 through C7.ResultsFor intrarater reliability, kappa coefficients ranged from .51 to .88 for the ER test, MSE, and PST, and ICCs ranged from .91 to .97 for ROM. For interrater reliability, kappa coefficients ranged from .74 to .96 for the ER test, MSE, and PST, and ICCs ranged from .90 to .95 for ROM.ConclusionsThe standardized clinical tests exhibited moderate to substantial reliability in patients with axial neck pain referred for diagnostic facet joint blocks. The data justify the incorporation of these tests into a clinical prediction model to screen patients before referral for diagnostic facet blocks.Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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