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Inter-Rater Reliability of Neck Reflex Points in Women with Chronic Neck Pain

Weinschenk, Stefan ; Göllner, Richard ; Hollmann, Markus W. ; Hotz, Lorenz ; Picardi, Susanne ; Hubbert, Katharina ; Strowitzki, Thomas ; Meuser, Thomas

In: Forschende Komplementärmedizin : Wissenschaft, Praxis, Perspektiven, 23 (2016), Nr. 4. pp. 223-229. ISSN 1661-4119 (Druck-Ausg.), 1421-9999 (Online-Ausg.)

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Background: Neck reflex points (NRP) are tender soft tissue areas of the cervical region that display reflectory changes in response to chronic inflammations of correlated regions in the visceral cranium. Six bilateral areas, NRP C0, C1, C2, C3, C4 and C7, are detectable by palpating the lateral neck. We investigated the inter-rater reliability of NRP to assess their potential clinical relevance. Methods: 32 consecutive patients with chronic neck pain were examined for NRP tenderness by an experienced physician and an inexperienced medical student in a blinded design. A detailed description of the palpation technique is included in this section. Absence of pain was defined as pain index (PI) = 0, slight tenderness = 1, and marked pain = 2. Findings were evaluated either by pair-wise Cohen’s kappa (ĸ) or by percentage of agreement (PA). Results: Examiners identified 40% and 41% of positive NRP, respectively (PI > 0, physician: 155, student: 157) with a slight preference for the left side (1.2:1). The number of patients identified with >6 positive NRP by the examiners was similar (13 vs. 12 patients). ĸ values ranged from 0.52 to 0.95. The overall kappa was ĸ = 0.80 for the left and ĸ = 0.74 for the right side. PA varied from 78.1% to 96.9% with strongest agreement at NRP C0, NRP C2, and NRP C7. Inter-rater agreement was independent of patients’ age, gender, body mass index and examiner’s experience. Conclusion: The high reproducibility suggests the clinical relevance of NRP in women.

Document type: Article
Journal or Publication Title: Forschende Komplementärmedizin : Wissenschaft, Praxis, Perspektiven
Volume: 23
Number: 4
Publisher: Karger
Place of Publication: Basel ; Karger
Date Deposited: 04 Nov 2019 09:42
Date: 2016
ISSN: 1661-4119 (Druck-Ausg.), 1421-9999 (Online-Ausg.)
Page Range: pp. 223-229
Faculties / Institutes: Medizinische Fakultät Heidelberg > Universitätsklinik für Anaesthesiologie
Medizinische Fakultät Heidelberg > Universitäts-Frauenklinik
DDC-classification: 610 Medical sciences Medicine
Uncontrolled Keywords: Nackenschmerzen , Muskel-Triggerpunkte , Neuroreflektorische , Veränderungen , Zahnherde , Neuraltherapie , cervical pain , muscular trigger points , neuroreflectory changes , dental focus , neural therapy
Additional Information: Dieser Beitrag ist aufgrund einer (DFG-geförderten) Allianz bzw. Nationallizenz frei zugänglich. This publication is freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.
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