Intrarater and Interrater Reliability of the Flexion Rotation Test and Cervical Range of Motion in People With Migraine

J Manipulative Physiol Ther. 2020 Nov-Dec;43(9):874-881. doi: 10.1016/j.jmpt.2019.11.005. Epub 2020 Aug 27.

Abstract

Objective: The aim of this study was to determine the reliability, standard error of measurement (SEM), and smallest detectable change (SDC) of the flexion rotation test (FRT) and cervical range of motion (CROM) assessed with the CROM device in individuals with and without migraine.

Methods: Twenty-five women with migraine (mean age, 35 years; standard deviation, 10 years) and 25 comparable headache-free women (mean age, 32 years; standard deviation, 11 years) participated in this study. C1/C2 mobility was assessed with the FRT, whereas global cervical range of motion was calculated using a CROM device. To assess the interrater reliability, tests were conducted on the same day at 20-minute intervals, by 2 independent assessors, and they were repeated after a 1-week interval by the same assessor to evaluate the intrarater reliability. The mean value of 3 repetitions was used to calculate the intraclass correlation coefficient ICC(2,k), SEM, and SDC.

Results: The intrarater reliability was excellent (ICC > 0.83), and interrater reliability ranged from substantial to excellent (ICC > 0.77) for the FRT. The SEM ranged from 2.44° to 2.85°, and the SDC from 6.78° to 7.9°. Intrarater and interrater reliability for cervical range of motion was substantial to excellent (ICC > 0.65), with the SEM ranging from 2.03° to 5.46° and the SDC from 5.6° to 15.14°.

Conclusion: The results demonstrate that FRT and global cervical range of motion with a CROM device show high reliability in individuals with migraine. In addition, the SEM and SDC were relatively small. Both assessments can be used for clinical evaluation of the cervical spine in individuals with migraine.

Keywords: Migraine Disorders; Range of Motion, Articular; Reproducibility of Results; Spine.

MeSH terms

  • Adult
  • Cervical Vertebrae / physiology
  • Cervical Vertebrae / physiopathology
  • Female
  • Humans
  • Migraine Disorders / physiopathology*
  • Neck* / physiology
  • Neck* / physiopathology
  • Physical Examination* / methods
  • Physical Examination* / standards
  • Range of Motion, Articular / physiology*
  • Reproducibility of Results
  • Rotation