Inter- and intra-rater-reliability of a clinical framework for spine-related neck-arm pain

C Kapitza; K Luedtke; M Komenda; M Kiefhaber; A B Schmid; N Ballenberger; B Tampin

doi:10.1016/j.msksp.2023.102853

Inter- and intra-rater-reliability of a clinical framework for spine-related neck-arm pain

Musculoskelet Sci Pract. 2023 Oct:67:102853. doi: 10.1016/j.msksp.2023.102853. Epub 2023 Aug 24.

Authors

C Kapitza¹, K Luedtke², M Komenda³, M Kiefhaber⁴, A B Schmid⁵, N Ballenberger³, B Tampin⁶

Affiliations

¹ Hochschule Osnabrueck, University of Applied Sciences, Faculty of Business, Management and Social Sciences, Department Movement and Rehabilitation Science, Osnabrueck, Germany; Universität zu Lübeck, Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), Luebeck, Germany. Electronic address: c.kapitza@hs-osnabrueck.de.
² Universität zu Lübeck, Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), Luebeck, Germany.
³ Hochschule Osnabrueck, University of Applied Sciences, Faculty of Business, Management and Social Sciences, Department Movement and Rehabilitation Science, Osnabrueck, Germany.
⁴ Praxis für Physiotherapie Kiefhaber, Bad Dürkheim, Germany.
⁵ Nuffield Department of Clinical Neurosciences, Oxford University, John Radcliffe Hospital, Headley Way, Oxford, UK.
⁶ Hochschule Osnabrueck, University of Applied Sciences, Faculty of Business, Management and Social Sciences, Department Movement and Rehabilitation Science, Osnabrueck, Germany; Department of Physiotherapy, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia.

PMID: 37657399
DOI: 10.1016/j.msksp.2023.102853

Abstract

Objective: A mechanism-based clinical framework for spine-related pain differentiates (i) somatic referred pain, ii) heightened nerve mechanosensitivity, iii) radicular pain, iv) radiculopathy and mixed-pain. This study aimed to determine the reliability of proposed framework.

Method: Fifty-one people with unilateral spine-related neck-arm pain were assessed and categorized by examiner-1. The classifications were compared to those made by two other examiners, based on written documentation of examiner-1. Cohens kappa was calculated between examiner-pairs; Fleiss Kappa among all examiners to assess agreement in classifying subgroups and entire framework.

Result: Inter-rater-reliability showed moderate to almost perfect reliability (somatic: no variation, mechanosensitivity: 0.96 (95% CI 0.87-1.0) to 1.0 (95% CI: 1.0-1.0), radicular pain: 0.46 (95% CI: 0.19-0.69) to 0.62 (95% CI: 0.42-0.81), radiculopathy: 0.65 (95% CI: 0.43-0.84) to 0.80 (95% CI: 0.63-0.96) mixed-pain: 0.54 (95% CI: 0.21-0.81) to 0.75 (95% CI: 0.48-0.94). There was almost perfect to moderate reliability among all examiners (somatic: no variation, mechanosensitivity: 0.97 (95% CI: 0.82-1.0), radicular pain: 0.56 (95% CI: 0.40-0.71), radiculopathy: 0.74 (95% CI: 0.58-0.90), mixed-pain: 0.63 (95% CI: 0.47-0.79), entire framework: 0.64 (95% CI: 0.57-0.71)). Intra-rater-reliability showed substantial to almost perfect reliability (somatic: no variation, mechanosensitivity: 0.96 (95% CI: 0.87-1.0), radicular pain: 0.76 (95% CI: 0.57-0.92), radiculopathy: 0.84 (95% CI: 0.67-0.96), mixed-pain: 0.83 (95% CI: 0.60-1.0), entire framework: 0.80 (95% CI: 0.61-0.92).

Conclusion: Moderate to almost perfect reliability in subgrouping people with spine-related neck-arm pain and substantial reliability for entire framework support this classification's reliability.

Keywords: Classification; Pain type; Reliability; Spine-related neck-arm pain.

MeSH terms

Humans
Musculoskeletal Pain*
Neck Pain / diagnosis
Radiculopathy* / diagnosis
Reproducibility of Results