Related Experiment Video
Updated: Aug 26, 2026
Precision Measurements and Parametric Models of Vertebral Endplates
Published on: September 17, 2019
The interexaminer reproducibility of physical examination of the cervical spine
Jan J Pool1, Jan L Hoving, Henrica C de Vet
1Institute for Research in Extramural Medicine, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands. j.pool@vumc.nl
Objective:
To assess the interexaminer reproducibility of physical examination of the cervical spine.
Methods:
Two physiotherapists independently judged the general mobility and the intersegmental mobility (segments C0-T2) of the neck and the pain that was provoked. Percentage agreement and Cohen's kappa expressed agreement of dichotomous variables; limits of agreement expressed agreement of continuous variables; and intraclass correlation coefficients (ICCs) expressed the reliability of continuous variables.
Results:
Agreement for general mobility showed kappa between 0.05 and 0.61, and for the intersegmental mobility, it showed kappa values between -0.09 and 0.63. Agreement for provoked neck pain within 1 point of an 11-point numerical rating scale (NRS) varied between 46.9% and 65.7% for general mobility and between 40.7% and 75.0% for intersegmental mobility. The ICCs varied between 0.36 and 0.71 for general mobility and between 0.22 and 0.80 for intersegmental mobility.
Conclusions:
Despite the use of a standardized protocol to assess general mobility and intersegmental mobility of the cervical spine, it is difficult to achieve reasonable agreement and reliability between 2 examiners. Likewise, the patients are not able to score the same level of provoked pain in 2 assessments with an interval of 15 minutes.
