Determining the reliability of craniocervical flexion test in asymptomatic individuals.
Seema Kotwani, D N Bid, Dinesh Ghatamaneni and 3 others
PMID 30930577WHAT IT FOUND
In 60 asymptomatic people, the craniocervical flexion test gave consistent scores when the same trained therapist repeated it after one week, and when two trained therapists tested each person.
Key findings
01The same tester’s scores were highly consistent, with an ICC of 0.986.
02The two testers’ scores agreed well, with an inter-rater ICC of 0.907.
03The reliability was tested only in asymptomatic people, so it does not show how the test performs in neck pain.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was done only in asymptomatic people, so it does not show whether the test is reliable in patients with neck pain. Both testers were experienced physiotherapists, so the results may not apply to less trained clinicians. The pressure device has an accuracy of ±3 mm Hg, which can introduce random error between tests. The cumulative performance index had not previously been used for inter-rater reliability in any population, and this was the first study to use it in an Indian population. The sample size calculations in the paper are inconsistent, saying that fewer than 15 subjects were needed while recruiting 60. None of the participants reached the 30 mm Hg target, and the reported mean scores were 10.80 and 10.83, while the table shows possible cumulative scores up to 300.
Declared interests
There are no conflicts of interest and no funding or supporting agencies.
The easy way to misread this
Do not conclude that the craniocervical flexion test is reliable for patients with neck pain. It was tested only in asymptomatic individuals, and the authors state that the results cannot be generalized.