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

*Corresponding author for this work


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.

Original languageEnglish
Article number102853
JournalMusculoskeletal Science and Practice
Publication statusPublished - 10.2023

Research Areas and Centers

  • Health Sciences

DFG Research Classification Scheme

  • 206-07 Clinical Neurology Neurosurgery and Neuroradiology

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