Concurrent validity and reliability of telerehabilitation-based physiotherapy assessment of cervical spine in adults with non-specific neck pain

J Telemed Telecare. 2021 Feb;27(2):88-97. doi: 10.1177/1357633X19861802. Epub 2019 Jul 4.


Introduction: The aim of this study was to determine the concurrent validity and reliability of telerehabilitation (TR)-based evaluation of the cervical spine among adults with non-specific neck pain (NS-NP).

Methods: A total of 11 participants with NS-NP were recruited. Pain intensity, active range of motion (AROM), posture, deep neck flexor (DNF) endurance, combined neck movements and disability were measured using face-to-face and TR methods, with a one-hour break in between. TelePTsys, an image-based TR system, was used for TR assessment.

Results: A high degree of concurrent validity for pain (bias = 0.90), posture (bias = 0.96°), endurance (bias = -2.3 seconds), disability (bias = 0.10), AROM (extension bias = -0.60 cm, flexion bias = 1.2 cm, side flexion bias = -1.00, rotation bias = -0.30 cm) was found. Standard error of measurement and coefficient of variation (CV) values were within the acceptable level for concurrent validity, except the CV for cervical flexion and endurance. There was a high degree of reliability demonstrated for pain, posture, AROM, endurance and disability measurements. The average-measure interclass correlation coefficient (ICC(3,1)) ranged from 0.96 to 0.99 for inter-rater, and 0.93 to 0.99 for intra-rater reliabilities. There was moderate agreement for combination movement for validity (78.5%, p < 0.05), inter- (78.5%, p < 0.05) and intra-rater (76.4%, p < 0.05) reliabilities.

Discussion: TR-based physiotherapy assessment of cervical spine is a valid and reliable tool for measuring pain intensity, AROM, DNF muscle endurance, sagittal neck posture and disability among adults with NS-NP via telePTsys.

Keywords: Telerehabilitation; neck pain; reliability; system; telePTsys; validity.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Cervical Vertebrae
  • Humans
  • Neck Pain* / therapy
  • Physical Therapy Modalities
  • Reproducibility of Results
  • Telerehabilitation*