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VOLUME 38 | NUMBER 10 | OCTOBER 2008 OCTOBER 2008
Volume 38, No. 10


Research Report

Intrarater Reliability of CROM Measurement of Cervical Spine Active Range of Motion in Persons With and Without Neck Pain

James P. Fletcher, William D. Bandy

DOI: 10.2519/jospt.2008.2680



STUDY DESIGN: Clinical measurement, intrarater reliability study. OBJECTIVES: To determine the intrarater reliability of cervical active range of motion (AROM) measurement of subjects with and without neck pain using the cervical range-of-motion device (CROM). BACKGROUND: Cervical spine AROM data are used by physical therapists to assist in identifying movement impairment, monitor patient progress, and evaluate the effectiveness of intervention. Presently, insufficient literature exists regarding the intrarater reliability of cervical AROM measurements using the CROM. METHODS AND MEASURES: Twenty-five adult subjects without neck pain and 22 adult subjects with neck pain volunteered for the study. Two trials of cervical AROM measurement (6 movements) were performed for each subject. Practice sessions, methods of measurement, and rest time between trials were standardized; order of measurement was randomized. RESULTS: The intraclass correlation coefficients (ICC3,1) for the subjects without neck pain ranged from 0.87 for flexion (95% confidence interval [CI]: 0.76-0.95) to 0.94 for left rotation (95% CI: 0.87-0.97). The standard error of the measurement ranged from 2.3° to 4.0°. The ICCs for the subjects with neck pain ranged from 0.88 for flexion (95% CI: 0.73-0.95) to 0.96 for left rotation (95% CI: 0.91-0.98). The standard error of the measurement ranged from 2.5° to 4.1°. Minimal detectable change ranged from 5.4° for left rotation in the subjects without neck pain to 9.6° for flexion in the subjects with neck pain. CONCLUSION: Intrarater reliability for cervical AROM measurement of persons with and without neck pain is sufficient to consider use of the CROM in clinical practice, although changes between 5° to 10° are needed to feel confident that a real change in spine mobility has occurred. 

J Orthop Sports Phys Ther. 2008;38(10):640-645, published online 11 July 2008. doi:10.2519/jospt.2008.2680

KEY WORDS: physical therapy, psychometrics, ROM


The authors determine the intrarater reliability of cervical active range of motion (AROM) measurement of subjects with and without neck pain using the cervical range of motion device (CROM).