Cervical nonorganic signs: a new clinical tool to assess abnormal illness behavior in neck pain patients: a pilot study.

Abstract:

OBJECTIVE:To develop and assess the reliability of a group of cervical nonorganic physical signs to be used as a simple screening tool for identifying patients with low neck pain who exhibit abnormal illness behavior. DESIGN:Survey, consecutive sample. DATA SET:Double masked. SETTING:Functional restoration program. PATIENTS:Twenty-six consecutive patients with complaints of chronic neck pain (greater than 4 months duration). Each patient was evaluated by a physician and then again by either a physical or occupational therapist, for the presence of specific cervical nonorganic signs. Both of the evaluations occurred on the same day. MAIN OUTCOME MEASURES:Five categories consisting of eight tests were appraised: (1) tenderness, (2) simulation, (3) range of motion, (4) regional disturbance, and (5) overreaction. RESULTS:The percent agreement between raters ranged from a high of 100% for regional sensory disturbance, to a low of 68% for one of the simulation tests. The average agreement between raters across all of the nonorganic test signs was 84.6%. Likewise, kappa coefficients ranged from 1.00 to .16, reflecting differences in strength of agreement. CONCLUSION:For many years, the lumbar nonorganic signs (developed by Waddell and colleagues) have been a useful screening tool in the assessment of abnormal illness behavior in the low back pain population. For the first time, a group of cervical nonorganic signs have been developed, standardized, and proven reliable.

journal_name

Arch Phys Med Rehabil

authors

Sobel JB,Sollenberger P,Robinson R,Polatin PB,Gatchel RJ

doi

10.1016/s0003-9993(00)90136-9

subject

Has Abstract

pub_date

2000-02-01 00:00:00

pages

170-5

issue

2

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(00)90136-9

journal_volume

81

pub_type

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