Interexaminer reliability of observations in physical examinations of the neck

The purpose of this study was to collect data on interexaminer reliability of a set of tests representative of the clinical examination of a patient with neck and radicular pain. A conventional neurological examination, palpations, and tests for the provocation or relief of radicular symptoms were performed on 52 patients by two independent raters. Good reliability was obtained in the atrophy inspection of the small muscles of the hand, in the sensitivity tests for touch and pain, and in the neck compression and axial manual traction tests. Fair reliability was obtained in muscle strength testing and in the estimation of the range of motion, and poor reliability was obtained for many palpations. Poor standardization of examination procedures and changes in the patients' attention were considered the main factors affecting reliability. Better operational definitions and procedures, such as the standardization of palpation pressure and traction force, are suggested for future studies.