Reliability of changes in neck pain and cervical rotation range following manual scapular repositioning

Abstract

Background: Manual scapular repositioning may result in change in neck pain and cervical rotation range. However, the reliability of such changes performed by examiners remains unknown.

Objective: To evaluate the reliability of changes in neck pain and cervical rotation range following manual scapular repositioning performed by two examiners and the agreement between these measures and patients' perceptions of change.

Design: Cross-sectional study.

Methods: Sixty-nine participants with neck pain and altered scapular position were recruited. Two physiotherapists performed the manual scapular repositioning. Neck pain intensity was measured using a 0-10 numerical scale and cervical rotation range with a cervical range of motion (CROM) device at baseline and in the modified scapular position. Participants' perceptions of any change were rated on a five-item Likert scale. Clinically relevant changes in pain (>2/10) and range (≥7°) were defined as "improved" or "no change" for each measure.

Results: ICCs for changes in pain and range between examiners were 0.92 and 0.91. For clinically relevant changes, percent agreement and kappa values between examiners were 82.6%, 0.64 for pain and 84.1%, 0.64 for range. Percent agreement and kappa values between participants' perceptions and measured changes were 76.1%, 0.51 for pain and 77.5%, 0.52 for range.

Conclusion: Changes in neck pain and rotation range following manual scapular repositioning demonstrated good reliability between examiners. There was moderate agreement between the measured changes and patients' perceptions.

Keywords: Agreement; Cervical spine; Clinical assessment; Posture; Scapula.