TY - JOUR
T1 - Cervical nonorganic signs
T2 - A new clinical tool to assess abnormal illness behavior in neck pain patients: A pilot study
AU - Sobel, Jerry B.
AU - Sollenberger, Patti
AU - Robinson, Richard
AU - Polatin, Peter B.
AU - Gatchel, Robert J.
PY - 2000/2
Y1 - 2000/2
N2 - 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. (C) 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.
AB - 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. (C) 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.
KW - Back pain
KW - Neck pain
KW - Nonorganic
KW - Psychosocial
KW - Rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=0033973349&partnerID=8YFLogxK
U2 - 10.1053/apmr.2000.0810170
DO - 10.1053/apmr.2000.0810170
M3 - Article
C2 - 10668770
AN - SCOPUS:0033973349
SN - 0003-9993
VL - 81
SP - 170
EP - 175
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 2
ER -