The Reliability And Validity Of Cervical Proprioceptive Assessment In Patients With Chronic Non-specific Neck Pain And Healthy Subjects

Objectives: To investigate the reliability and validity of cervical relocation test(CRT)and cervical movement sense test(CMST)in patients with chronic non-specific neck pain and healthy subjects,and its correlation with neck disability index and pain intensity.Methods: This study includes two parts.Part1,the intra-and inter-rater reliability of the CRT were assessed in 32 patients with chronic non-specific neck pain and 30 healthy subjects.Cervical JPE was measured by two independent assessors respectively in four directions of cervical motion: cervical flexion,extension,rotation left,and rotation right,and the difference in JPE between two groups was also determined for validity study.Part2,another 49 subjects including 25 chronic non-specific neck pain and 24 healthy subjects,participated pattern tracing tasks.The “zz” and “∞” patterns were used to assess cervical movement sense.The performance of the subjects were videoed and later examined.Time(total time taken to complete the task),Error frequency(number of deviations)were recorded.Two assessors independently evaluated the laser tracing videos in slow motion.A laser pointer was used for both proprioceptive tests above,intra-and inter-rater reliability were assessed using intraclass correlation coefficient(ICC).Results: The intra-and inter-rater reliability for the CRT had intraclass correlation coefficient(ICC)values of 0.603～0.830 and 0.597～0.837,standard error of measurement(SEM)values of 1.516～2.154 cm and 1.691～2.089 cm,minimal detectable change(MDC)values of 4.203～5.972 cm and 4.687～5.789 cm,respectively;patients with chronic non-specific neck pain had significantly larger JPE in cervical extension(P<0.01)and right rotation(P<0.05)compared to healthy subjects,JPE for extension had AUC values of0.755.The intra-rater reliability for CMST had ICC values of 0.999～1 and SEM of 0～1.656 for Time,ICC values of 0.939～0.959 and SEM of 1.638～3.475 for Error frequency;inter-rater reliability had ICC values of 0.995～0.998(SEM:2.343～3.820)and 0.826～0.894(SEM:3.440～5.147)for Time and Error frequency.There is no statistical significance between two groups.Conclusions: Intra-and inter-rater reliability were good for both cervical proprioceptive tests.JPE for cervical extension may able to discriminate chronic non-specific neck pain from healthy subjects.Pattern tracing tasks maybe not sensitive to neck pain patients with mild cervical dysfunction.It is suggested that MDC and SEM should be fully considered during the test.