Document Detail


Long-term stability and minimal detectable change of the cervical flexion-rotation test.
MedLine Citation:
PMID:  20357415     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Reliability of clinical measurements over time. OBJECTIVES: To determine the long-term stability and minimal detectable change (MDC) of the flexion-rotation test (FRT) measurements over days in subjects with cervicogenic headache (CGH). BACKGROUND: The FRT is used by physical therapists to assist in identifying upper cervical movement impairment, as well as to gauge treatment effectiveness. Test-retest reliability for the FRT has been reported, but the stability of range-of-motion measures taken during the FRT over time and the MDC have not been investigated. METHODS: Fifteen subjects with CGH were evaluated on headache-free days using the FRT by a blinded examiner at baseline, 2, 4, and 14 days later. An additional 10 asymptomatic subjects were included for blinding purposes. On each occasion, the examiner measured range of motion and determined whether the FRT was positive or negative. RESULTS: For subjects with CGH, there was no significant change in FRT range of motion over days (P>.05). Intraclass correlation coefficients for intratester reliability were 0.95 (95% CI: 0.90 to 0.98) and 0.97 (95% CI: 0.94 to 0.99) for right and left rotation, respectively. MDC90 was 4.7 degrees for right rotation and 7 degrees for left rotation. Examiner interpretation of the FRT was consistent over time, with kappa = 0.92. CONCLUSIONS: This study provides evidence that FRT measurements are stable over time, and the MDC90 indicates that a change in FRT range of motion of at least 7 degrees is required to be confident that a change has occurred due to an intervention rather than measurement error.
Authors:
Toby Hall; Kathy Briffa; Diana Hopper; Kim Robinson
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  The Journal of orthopaedic and sports physical therapy     Volume:  40     ISSN:  0190-6011     ISO Abbreviation:  J Orthop Sports Phys Ther     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-01     Completed Date:  2010-05-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7908150     Medline TA:  J Orthop Sports Phys Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  225-9     Citation Subset:  IM    
Affiliation:
School of Physiotherapy, Curtin Innovation Health Research Institute, Curtin University of Technology, Bentley, Western Australia. halltm@netspace.net.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Cervical Vertebrae / physiology,  physiopathology*
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Observer Variation
Physical Examination / methods,  standards*
Post-Traumatic Headache / diagnosis*
Range of Motion, Articular*
Reference Values
Reproducibility of Results
Rotation
Sensitivity and Specificity
Time Factors
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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