Reliability of a clinical test for deep cervical flexor endurance

J Manipulative Physiol Ther. 2006 Feb;29(2):134-8. doi: 10.1016/j.jmpt.2005.12.009.


Objective: Endurance deficiencies of the deep cervical flexors are associated with pain, increased lordosis, and headache. A need exists for reliable clinical tests of flexor endurance. This study determined intrarater and interrater reliability of such a test in persons without neck pain.

Methods: Twenty-seven subjects (aged 20-35 years) without a history of neck pain or injury were tested. Supine subjects were timed in maintaining a position involving two components: (1) craniovertebral flexion (chin tuck) and (2) lower cervical flexion (holding the occiput at a fixed height). Each subject was examined twice by 3 different examiners with 1 to 2 days between trials.

Results: When two values were averaged, interrater reliability for the 3 testers was 0.83, 0.85, and 0.88. Intrarater reliability values were 0.78 and 0.85 for tests 1 and 2, respectively.

Conclusions: The flexor endurance test showed good intertester and intratester reliability when two values were averaged and, thus, may represent a useful clinical tool for practitioners involved in treating and preventing neck pain.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Diagnostic Tests, Routine / standards*
  • Female
  • Humans
  • Male
  • Movement
  • Muscular Diseases / diagnosis
  • Neck Muscles / physiology*
  • Observer Variation
  • Physical Endurance*
  • Posture
  • Reference Values
  • Reproducibility of Results
  • Supine Position