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The validity and intertester reliability of cervical range of motion using inclinometer measurements

1 May 1995


Medical personnel routinely measure cervical range of motion during the evaluation and treatment of neck and arm complaints. The purpose of this study was to test the validity and reliability of three inclinometer methods used to measure cervical range. Thirty-four therapists measured rotation, lateral flexion, flexion, and extension in the cervical spine. The therapists were asked to follow published guidelines of the American Medical Association for the single and double inclinometer methods as well as guidelines using a stabilization method. A single subject was the model for each plane of movement, and every therapist measured each subject in each plane of movement, three times. The therapists did this for each of three different methods, which included, the single inclinometer, the double inclinometer, and a stabilization method which used one inclinometer. Radiographs were then taken of the models in the plane of motion used for the study and measured for the range of motion. A CT scan was used for measuring rotation. Results indicate that all the single and double methods in flexion, and all the methods in extension were statistically valid. The stabilization method had the highest consistency in all planes except rotation where it was not used. The stabilization method also had the highest intertester reliability for left lateral flexion with an ICC value of .94. However, it had the lowest intertester reliability for extension with an ICC of .89. Double inclinometer flexion also had an ICC of .89 for intertester reliability. Based on the results and video analysis of the therapists during testing, suggestions for obtaining more accurate results as well as suggestions for future studies are discussed. Some of the suggestions include: using a chair that supports the scapula in a standardized position; having the patient perform lateral flexion in front of a mirror to minimize the chance of a rotational coupling motion accompanying lateral side bending; and measuring flexion followed by extension in one motion without resetting the inclinometer at neutral.


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