Reliability of measurements of cervical spine range of motion--comparison of three methods

To determine reliabilities within and between persons measuring cervical active range of motion (AROM) three methods were examined: use of a cervical-range-of-motion (CROM) instrument, use of a universal goniometer (UG), and visual estimation (VE). Measurements were made on 60 patients with orthopedic disorders of the cervical spine who were divided into three groups of 20 subjects each. All subjects were tested in a standardized seated position using operationally defined goniometric placements and nongoniometric estimation techniques. Cervical flexion and extension, lateral flexion, and rotation were measured. Intraclass correlation coefficients (ICCs) were used to quantify within-tester and between-tester reliability. We found that goniometric measurements of AROM of the cervical spine made by the same physical therapist had ICCs greater than .80 when made with the CROM device or the UG. When different physical therapist measured the same patient's cervical AROM, the CROM device had ICCs greater than .80, whereas the UG and VE generally had ICCs less than .80.