Differences in isometric neck muscle strength between healthy controls and women with chronic neck pain: the use of a reliable measurement

Arch Phys Med Rehabil. 2007 Nov;88(11):1441-5. doi: 10.1016/j.apmr.2007.06.776.


Objectives: To determine the intra- and interrater reliability of the Biodex isokinetic dynamometer to measure the maximal isometric strength of the cervical flexors and extensors, to develop an age- and sex-based normative database in a healthy population, and to evaluate the differences in neck strength between women with chronic neck pain and healthy controls.

Design: Cross-sectional.

Setting: Physical and rehabilitation medicine department.

Participants: Ninety-six healthy volunteers (4 age groups: 20-29, 30-39, 40-49, 50-59y; each consisting of 12 men and 12 women) and 30 women with chronic neck pain.

Interventions: Not applicable.

Main outcome measures: Peak isometric strength of the cervical muscles was tested for flexion and extension by using the Biodex isokinetic dynamometer. The intra- and interrater reliability of the protocol was evaluated in 12 volunteers.

Results: The reliability for strength was high for both flexion and extension (intraclass correlation coefficient, .92-.96). The mean peak torque for flexion and extension was significantly higher in men (24Nm, 36.4Nm, respectively) compared with women (16.6Nm, 26.5Nm, respectively) (P<.001). Peak torque production for extension was significantly lower in the patient group (22.3Nm) compared with the healthy female control group (26.5Nm) (P=.003). No significant differences in flexion strength between patient and female control group were found.

Conclusions: Results show a high degree of intra- and interrater reliability in measuring isometric neck muscle strength when using the Biodex isokinetic dynamometer. The use of normative data for neck strength when evaluating patients with neck disorders needs to take sex into account. The current study has shown that women with chronic neck pain have lower neck muscle strength in extension than the healthy female group.

MeSH terms

  • Adult
  • Female
  • Humans
  • Isometric Contraction / physiology*
  • Male
  • Middle Aged
  • Muscle Strength / physiology*
  • Muscle Strength Dynamometer / statistics & numerical data*
  • Neck Muscles / physiopathology
  • Neck Pain / physiopathology
  • Neck Pain / rehabilitation*
  • Observer Variation
  • Reference Values
  • Reproducibility of Results
  • Sex Factors