Faculty Collaboration Database

Inter-Rater Reliability of Neck Reflex Points in Women with Chronic Neck Pain. Forsch Komplementmed 2016;23(4):223-9

Date

09/09/2016

Pubmed ID

27607183

DOI

10.1159/000447506

Scopus ID

2-s2.0-84976277593 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

BACKGROUND: Neck reflex points (NRP) are tender soft tissue areas of the cervical region that display reflectory changes in response to chronic inflammations of correlated regions in the visceral cranium. Six bilateral areas, NRP C0, C1, C2, C3, C4 and C7, are detectable by palpating the lateral neck. We investigated the inter-rater reliability of NRP to assess their potential clinical relevance.

METHODS: 32 consecutive patients with chronic neck pain were examined for NRP tenderness by an experienced physician and an inexperienced medical student in a blinded design. A detailed description of the palpation technique is included in this section. Absence of pain was defined as pain index (PI) = 0, slight tenderness = 1, and marked pain = 2. Findings were evaluated either by pair-wise Cohen's kappa (ĸ) or by percentage of agreement (PA).

RESULTS: Examiners identified 40% and 41% of positive NRP, respectively (PI > 0, physician: 155, student: 157) with a slight preference for the left side (1.2:1). The number of patients identified with >6 positive NRP by the examiners was similar (13 vs. 12 patients). ĸ values ranged from 0.52 to 0.95. The overall kappa was ĸ = 0.80 for the left and ĸ = 0.74 for the right side. PA varied from 78.1% to 96.9% with strongest agreement at NRP C0, NRP C2, and NRP C7. Inter-rater agreement was independent of patients' age, gender, body mass index and examiner's experience.

CONCLUSION: The high reproducibility suggests the clinical relevance of NRP in women.

Author List

Weinschenk S, Göllner R, Hollmann MW, Hotz L, Picardi S, Hubbert K, Strowitzki T, Meuser T, Heidelberg University Neural Therapy Education and Research Group (The HUNTER group)h

Author

Thomas Meuser MD Associate Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Chronic Pain
Double-Blind Method
Female
Humans
Male
Middle Aged
Neck Pain
Observer Variation
Pain Measurement
Palpation
Students, Medical
Trigger Points