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European Spine Journal

, Volume 26, Issue 9, pp 2225–2241 | Cite as

Reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders: Part 1—A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) Collaboration

  • Nadège Lemeunier
  • S. da Silva-Oolup
  • N. Chow
  • D. Southerst
  • L. Carroll
  • J. J. Wong
  • H. Shearer
  • P. Mastragostino
  • J. Cox
  • E. Côté
  • K. Murnaghan
  • D. Sutton
  • P. Côté
Review

Abstract

Objective

To determine the reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders.

Methods

We updated the systematic review of the 2000–2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders. We also searched the literature to identify studies on the reliability and validity of Doppler velocimetry for the evaluation of cervical arteries. Two independent reviewers screened and critically appraised studies. We conducted a best evidence synthesis of low risk of bias studies and ranked the phases of investigations using the classification proposed by Sackett and Haynes.

Results

We screened 9022 articles and critically appraised 8 studies; all 8 studies had low risk of bias (three reliability and five validity Phase II–III studies). Preliminary evidence suggests that the extension–rotation test may be reliable and has adequate validity to rule out pain arising from facet joints. The evidence suggests variable reliability and preliminary validity for the evaluation of cervical radiculopathy including neurological examination (manual motor testing, dermatomal sensory testing, deep tendon reflexes, and pathological reflex testing), Spurling’s and the upper limb neurodynamic tests. No evidence was found for doppler velocimetry.

Conclusions

Little evidence exists to support the use of clinical tests to evaluate the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. We found preliminary evidence to support the use of the extension–rotation test, neurological examination, Spurling’s and the upper limb neurodynamic tests.

Keywords

Neck pain Assessment Diagnosis Neurological tests Vertebrobasilar insufficiency Stenosis Dissection stroke Doppler velocimeter 

Notes

Acknowledgements

The authors acknowledge and thank Mrs. Sophie Despeyroux, librarian at the Haute Autorité de Santé, for her suggestions and review of the search strategy. This research was undertaken, in part, thanks to funding and supervision from the Canada Research Chairs program to Dr. Pierre Côté, Canada Research Chair in Disability Prevention and Rehabilitation at the University of Ontario Institute of Technology.

Compliance with ethical standards

Funding

This study was funded by the Institut Franco-Européen de Chiropraxie, the Association Française de Chiropraxie, and the Fondation de recherche en chiropraxie in France. None of these associations were involved in the collection of data, data analysis, interpretation of data, or drafting of the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

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Supplementary material 5 (DOCX 14 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Nadège Lemeunier
    • 1
    • 2
  • S. da Silva-Oolup
    • 3
  • N. Chow
    • 3
    • 4
  • D. Southerst
    • 5
  • L. Carroll
    • 6
  • J. J. Wong
    • 2
  • H. Shearer
    • 2
    • 3
  • P. Mastragostino
    • 3
  • J. Cox
    • 3
  • E. Côté
    • 7
  • K. Murnaghan
    • 8
  • D. Sutton
    • 2
  • P. Côté
    • 2
    • 9
  1. 1.Institut Franco-Européen de ChiropraxieToulouseFrance
  2. 2.UOIT-CMCC Centre for the Study of Disability Prevention and RehabilitationUniversity of Ontario Institute of Technology (UOIT)OshawaCanada
  3. 3.Division of Graduate Education and ResearchCanadian Memorial Chiropractic College (CMCC)TorontoCanada
  4. 4.Michael G. DeGroote Institute for Pain Research and CareMcMaster UniversityHamiltonCanada
  5. 5.Occupational and Industrial Orthopaedic Centre, Department of Orthopaedic SurgeryNYU Hospital for Joint DiseasesNew YorkUSA
  6. 6.School of Public HealthUniversity of AlbertaEdmontonCanada
  7. 7.Faculty of MedicineUniversity of TorontoTorontoCanada
  8. 8.Canadian Memorial Chiropractic College (CMCC)TorontoCanada
  9. 9.Faculty of Health SciencesUniversity of Ontario Institute of Technology (UOIT)OshawaCanada

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