Objective: To examine the test–retest reliability and construct validity of cervical active range of motion and isometric neck muscle strength as measured by the Multi Cervical Rehabilitation Unit (Hanoun Medical Inc., Ontario).
Design: A cross-sectional study.
Setting: Institutional practice.
Subjects: Twenty-one patients with neck pain and 25 healthy volunteers.
Methods: After a trial-run session, active range of motion (AROM) was measured in the subsequent two sessions, with 2–3 days in between. During each session, three measurements were taken for each direction (flexion, extension, lateral flexions and rotations). The measurement of isometric strength was after a 15-minute break following completion of the measurement of AROM. Three measurements were made for each of the six directions (flexion, extension, lateral flexions, protraction and retraction). The software of the Multi Cervical Rehabilitation Unit automatically recorded and calculated the maximum AROM and isometric strength.
Results: There was a good to high level of reliability in the measurement of AROM for both groups of subjects, with intraclass correlation coefficients (ICCs) ranging from 0.81 to 0.96. Results also demonstrated very good to excellent reliability in isometric strength measurement (ICCs ranged from 0.92 to 0.99). Moreover, there was a significant difference in isometric neck muscle strength (p = 0.001) and in AROM (p = 0.034) between the two groups.
Conclusions: The Multi Cervical Rehabilitation Unit was found to be reliable and valid for testing the cervical active range of motion and isometric neck muscle strength for both normal and patient subjects.
References
1.
Andersson HI, Ejlertsson G, Leden I, Rosenberg C. Chronic pain in a geographically defined general population:studies of differences in age, gender, social class, and pain localization. Clin J Pain1993; 9:174–182.
2.
Hasvold T, Johnsen R. Headache and neck or shoulder pain – frequent and disabling complaints in the general population. Scand J Prim Health Care1993; 23:127–133.
3.
Lau EMC, Sham A, Wong KC. The prevalence of and risk factors for neck pain in Hong Kong Chinese. J Public Health Med1996; 18:396–399.
4.
Kamwendo K, Linton SJ, Mortiz U. Neck and shoulder disorders in medical secretaries. Part I:Pain prevalence and risk factors. Scand J Rehabil Med1991; 23:127–133.
5.
Maeda K. Occupational cervicobrachial disorder and its causative factor. J Hum Ergol1977; 6:193–202.
6.
Cote P, Cassidy DJ, Carroll L. The Saskatchewan health and back pain survey. The prevalence of neck pain and related disability in Saskatchewan adults. Spine1998; 23:1689–1698.
7.
Rempel DM, Harrison RJBarnhart S. Work related cumulative trauma disorders of the upper extremity. JAMA1992; 267:838–842.
8.
Chen J, Solinger AB, Poncet JF, Lantz CA. Meta-analysis of normal cervical motion. Spine1999; 24:1571–1578.
9.
Barton PM, Hayes KC. Neck flexor muscle strength, efficiency, and relaxation times in normal subjects and subjects with unilateral neck pain and headache. Arch Phys Med Rehabil1996; 77:680–687.
10.
Jordan A, Bendix T, Nielsen H, Hansen FR, Host D, Winkel A. Intensive training, physiotherapy, or manipulation for patients with chronic neck pain:A prospective, single-blinded, randomized clinical trial. Spine1998; 23:311–319.
11.
Leggett SH, Graves JE, Pollock ML et al. Quantitative assessment and training of isometric cervical extension strength. Am J Sports Med1991; 19:653–659.
12.
Ylinen J, Ruuska J. Clinical use of neck isometric strength measurement in rehabilitation. Arch Phys Med Rehabil1994; 75:465–469.
13.
Cole TM. Measurement of musculoskeletal function:goniometry. In:Kottke FJ, Stillwell GK, Lehmann JF eds. Krusens's handbook of physical medicine and rehabilitation, third edition. Philadelphia:Saunders, 1982.
14.
Moll JMH, Wright V. Measurement of joint motion. Clin Rheum Dis1976; 2:3–26.
15.
Youdas JW, Carey JR, Garrett TR. Reliability of measurements of cervical spine range of motion – comparison of three methods. Phys Ther1991; 71:98–106.
16.
Hintze JL. Power Analysis and Sample Size for Windows. PASS, NCSS, Kaysville, Utah, USA, 1996.
17.
Cohen J. Statistical power analysis for the behavioural sciences. New York:Academic Press, 1977.
18.
Safrit MJ, ed. Reliability theory. Physical education and recreation. American Alliance for Health, 1976:32–35.
19.
Hochberg Y, Benjamini Y. More powerful procedure for multiple significance testing. Stat Med1990; 9:811–818.
20.
Blesh TE. Measurement in physical education, second edition. New York:The Ronald Press Co, 1974.
21.
Youdas JW, Garrett TR, Suman VJ, Bogard CL, Hallman HO, Carey JR. Normal range of motion of the cervical spine:an initial goniometric study. Phys Ther1992; 72:770–780.
22.
Kuhlman KA. Cervical range of motion in the elderly. Arch Phys Med Rehabil1993; 74:1071–1079.
23.
Penning L, Wilmink JT. Rotation of the cervical spine. A CT study in normal subjects. Spine1987; 12:732–738.
24.
Highland TR, Dreisinger TE, Laura LV, Russell GS. Changes in isometric strength and range of motion of the isolated cervical spine after eight weeks of clinical rehabilitation. Spine1992; 17(6 suppl):S77–S82.
25.
Silverman JL, Rodriquez AA, Agre JC. Quantitative cervical flexor strength in healthy subjects and in subjects with mechanical neck pain. Arch Phys Med Rehabil1991; 72:679–681.
26.
Vernon HT, Aker P, Aramenko M, Battershill D, Alepin A, Penner T. Evaluation of neck muscle strength with a modified sphygmomanometer dynamometer:reliability and validity. J Manipulative Physiol Ther1992; 15:343–349.
27.
Jordan A, Mehlsen J, Bülow PM, Østergaard K, Danneskiold-Samsøe B. Maximal isometric strength of the cervical musculature in 100 healthy volunteers. Spine1999; 24:1343–1348.
