Reference values, minimum repetitions for stable measures, and test-retest reliability in the torsion and conventional cervical joint position sense tests in asymptomatic individuals

Abstract

ObjectiveTo determine reference values, including the appropriate number of repetitions, and test-retest reliability of the torsion and conventional cervical joint position sense (JPS) tests. MethodsPhase 1) Cross-sectional design to determine reference values and the appropriate number of repetitions; Phase 2) repeated-measures concordance design (test-retest reliability). Sixty-eight healthy participants performed 10 repetitions of randomized rotation left and right for both cervical JPS tests using a laser projected onto a target. Thirty participants returned for the same evaluation process one week later. ResultsThe age-stratified reference values for the torsion JPS test showed greater absolute error as age increased. Stable levels of performance were obtained with 6–7 repetitions for both tests. Moderate to good reliability was found with 7 or more repetitions for left rotation [Torsion JPS test, Intraclass Correlation Coefficient (ICC; 95% CI) = 0.85 (0.68–0.93); Conventional JPS test, ICC = 0.78 (0.53–0.89)], and 6–7 or more repetitions for right rotation [Torsion JPS test, 6 repetitions, ICC = 0.79 (0.56–0.90); Conventional JPS test, 7 repetitions, ICC = 0.82 (0.61–0.91)]. Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) stabilized at 7 repetitions in both tests [Torsion JPS test (SEM ≤ 1.0°; MDC90 ≤ 2.4°; MDC95 ≤ 2.9°); Conventional JPS test (SEM ≤ 1.2°; MDC90 ≤ 2.8°; MDC95 ≤ 3.3°)]. ConclusionsThe reference values generated for the torsion JPS test may help identify the presence of impairments cervical proprioception. At least 7 repetitions optimize stability, reliability and responsiveness in the torsion and conventional cervical JPS tests.