Accessory and physiological movement tests used during the cervical
spine examination: an update an physical therapists’ attitudes and
approaches survey
Abstract
Objective: A correct examination is essential during a differential
diagnosis of neck pain patients. Therefore, the objective of this study
was to provide an update on the properties considered most important by
PTs when conducting accessory and physiological movement tests during
the cervical spine physical examination. Methods: A total of 84 private
physiotherapy centres participated in this online cross-sectional survey
including 415 active physiotherapists and members of one autonomous
Spanish Physiotherapists School. The main outcome measures were the
frequency and the importance of mobility and pain responses assessed
during cervical spine examination and the most commonly utilized
reference to make a judgement. Results: Pain responses are most
frequently used by physiotherapists at a rate of 79.8% and also rated
as important by 42.65% respondents mobility aspects such as quality of
end-feel (17.3%), quantity of translation (16.4%) and quality of
resistance (13.3%) during passive accessory intervertebral movement
tests. During passive and active physiological movement tests, the most
frequent properties assessed were the quality of motion path (80,5% and
84.3% respectively) and quantity of angle bending (81,7% and 77.6%
respectively). Pain responses are used as reference by 54.7% to make a
clinical judgement during passive accessory intervertebral movement
tests. Conclusion: Physical therapists face validity in relation to
passive accessory intervertebral movement test for assessing spinal
segmental motion aspects has been decreasing with more attention devoted
to pain responses. The current skepticism regarding the motion
properties assessed with these tests is associated with utility aspects
such as validity, sensitivity, accuracy and specificity.