Movement Control Impairment Research Articles

Correlation between lumbar dysfunction and fat infiltration in lumbar multifidus muscles in patients with low back pain

Lumbar multifidus muscles (LMM) are important for spinal motion and stability. Low back pain (LBP) is often associated with fat infiltration in LMM. An increasing fat infiltration of LMM may lead to lumbar dysfunction. The purpose of this study was to investigate whether there is a correlation between the severity of lumbar dysfunction and the severity of fat infiltration of LMM. In a cross-sectional study, 42 patients with acute or chronic LBP were recruited. Their MRI findings were visually rated and graded using three criteria for fat accumulation in LMM: Grade 0 (0–10%), Grade 1 (10–50%) and Grade 2 (>50%). Lumbar sagittal range of motion, dynamic upright and seated posture control, sagittal movement control, body awareness and self-assessed functional disability were measured to determine the patients’ low back dysfunction. The main result of this study was that increased severity of fat infiltration in the lumbar multifidus muscles correlated significantly with decreased range of motion of lumbar flexion (p = 0.032). No significant correlation was found between the severity of fat infiltration in LMM and impaired movement control, posture control, body awareness or self-assessed functional disability. This is the first study investigating the relationship between the severity of fat infiltration in LMM and the severity of lumbar dysfunction. The results of this study will contribute to the understanding of the mechanisms leading to fat infiltration of LMM and its relation to spinal function. Further studies should investigate whether specific treatment strategies are effective in reducing or preventing fat infiltration of LMM.

Sub-classification based specific movement control exercises are superior to general exercise in sub-acute low back pain when both are combined with manual therapy: A randomized controlled trial.

BackgroundClinical guidelines recommend research on sub-groups of patients with low back pain (LBP) but, to date, only few studies have been published. One sub-group of LBP is movement control impairment (MCI) and clinical tests to identify this sub-group have been developed. Also, exercises appear to be beneficial for the management of chronic LBP (CLBP), but very little is known about the management of sub-acute LBP.MethodsA randomized controlled trial (RCT) was conducted to compare the effects of general exercise versus specific movement control exercise (SMCE) on disability and function in patients with MCI within the recurrent sub-acute LBP group. Participants having a MCI attended five treatment sessions of either specific or general exercises. In both groups a short application of manual therapy was applied. The primary outcome was disability, assessed by the Roland-Morris Disability Questionnaire (RMDQ). The measurements were taken at baseline, immediately after the three months intervention and at twelve-month follow-up.ResultsSeventy patients met the inclusion criteria and were eligible for the trial. Measurements of 61 patients (SMCE n = 30 and general exercise n = 31) were completed at twelve months. (Drop-out rate 12.9 %). Patients in both groups reported significantly less disability (RMDQ) at twelve months follow-up. However, the mean change on the RMDQ between baseline and the twelve-month measurement showed statistically significantly superior improvement for the SMCE group -1.9 points (-3.9 to -0.5) 95 % (CI). The result did not reach the clinically significant three point difference. There was no statistical difference between the groups measured with Oswestry Disability Index (ODI).ConclusionFor subjects with non-specific recurrent sub-acute LBP and MCI an intervention consisting of SMCE and manual therapy combined may be superior to general exercise combined with manual therapy.Trial registrationThe study protocol registration number is ISRCTN48684087. It was registered retrospectively 18th Jan 2012.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-0986-y) contains supplementary material, which is available to authorized users.

Spinal inhibition and motor function in adults with spastic cerebral palsy.

Abnormal activation of motoneurons in the spinal cord by sensory pathways is thought to contribute to impaired movement control and spasticity in individuals with cerebral palsy. Here we use single motor unit recordings to show how individual motoneurons in the spinal cord respond to sensory inputs in a group of participants with cerebral palsy having different degrees of motor dysfunction. In participants who had problems walking independently and required assistive devices such as wheelchairs, sensory pathways only excited motoneurons in the spinal cord. In contrast, in participants with cerebral palsy who walked independently for long distances, sensory inputs both inhibited and excited motoneurons in the spinal cord, similar to what we found in uninjured control participants. These findings demonstrate that in individuals with severe cerebral palsy, inhibitory control of motoneurons from sensory pathways is reduced and may contribute to motor dysfunction and spasticity. Reduced inhibition of spinal motoneurons by sensory pathways may contribute to heightened reflex activity, spasticity and impaired motor function in individuals with cerebral palsy (CP). To measure if the activation of inhibitory post-synaptic potentials (IPSPs) by sensory inputs is reduced in CP, the tonic discharge rate of single motor units from the soleus muscle was plotted time-locked to the occurrence of a sensory stimulation to produce peri-stimulus frequencygrams (PSFs). Stimulation to the medial arch of the foot was used to activate cutaneomuscular afferents in 17 adults with bilateral spastic CP and 15 neurologically intact (NI) peers. Evidence of IPSP activation from the PSF profiles, namely a marked pause or reduction in motor unit firing rates at the onset of the cutaneomuscular reflex, was found in all NI participants but in only half of participants with CP. In the other half of the participants with CP, stimulation of cutaneomuscular afferents produced a PSF profile indicative of a pure excitatory post-synaptic potential, with firing rates increasing above the mean pre-stimulus rate for 300ms or more. The amplitude of motoneuron inhibition during the period of IPSP activation, as measured from the surface EMG, was less in participants with poor motor function as evaluated with the Gross Motor Functional Classification System (r=0.72, P<0.001) and the Functional Mobility Scale (r=-0.82, P<0.001). These findings demonstrate that in individuals with CP, reduced activation of motoneuron IPSPs by sensory inputs is associated with reduced motor function and may contribute to enhanced reflexes and spasticity in CP.

Core Stabilization Exercise and Movement System Impairment Approaches for Patients with Movement Control Impairment: A Review Article

Treatment-based and movement system impairment-based classifications have been widely used to identify movement control impairment (MCI) in patients with non-specific low back pain. Clinical observation of aberrant movement patterns is an essential aspect of the examination to identify patients with MCI. The treatment of these patients is a therapeutic exercise that involves static and dynamic stability of core stabilizing muscles. Although exercise prescriptions for these patients are similar, intervention may vary based upon its concept. Interventions include the core stabilization exercise (CSE) approach based upon stabilizing system model, and movement system impairment (MSI) approach based upon kinesiopathologic model. CSE focuses on neuromuscular function to compensate for impairment of intervertebral disc and joints, whereas MSI emphasizes movement correction and enhances movement efficiency to prevent injury and impairment. Both approaches seem equally effective in reducing pain and disability for the MCI group. Therefore, clinicians can utilize either approach for rehabilitating patients with MCI. However, if differences in effectiveness are found when utilizing these different approaches we should explore if the MCI classification needs further definition. In addition, further study needs to investigate the underlying mechanisms in patients with MCI, and the ability of each approach to change those mechanisms.

Pain intensity attenuates movement control of the lumbar spine in low back pain

Introduction: Pain intensity attenuates muscular activity, proprioception, and tactile acuity, with consequent changes of joint kinematics. People suffering from low back pain (LBP) frequently show movement control impairments of the lumbar spine in sagittal plane. This cross-sectional, observational study investigated if the intensity of LBP attenuates lumbar movement control. The hypothesis was that lumbar movement control becomes more limited with increased pain intensity. Methods: The effect of LBP intensity, measured with a numeric rating scale (NRS), on lumbar movement control was tested using three movement control tests. The lumbar range of motion (ROM), the ratio of lumbar and hip ROM as indicators of direction specific movement control, and the recurrence and determinism of repetitive lumbar movement patterns were assessed in ninety-four persons suffering from LBP of different intensity and measured with an inertial measurement unit system. Generalized linear models were fitted for each outcome. Results: Lumbar ROM (+0.03°, p=0.24) and ratio of lumbar and hip ROM (0.01, p=0.84) were unaffected by LBP intensity. Each one point increase on the NRS resulted in a decrease of recurrence and determinism of lumbar movement patterns (−3.11 to −0.06, p⩽0.05). Discussion: Our results indicate changes in movement control in people suffering from LBP. Whether decreased recurrence and determinism of lumbar movement patterns are intensifiers of LBP intensity or a consequence thereof should be addressed in a future prospective study.

A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: Short-term results of a randomised controlled trial

Exercise is an effective treatment for patients with sub-acute and chronic low back pain (LBP). Patients with a movement control impairment (MCI) can be diagnosed as a subgroup of patients with LBP. Unknown is which exercise intervention is most beneficial for this subgroup. This study assessed the short-term effect of a specific exercise program targeting movement control impairment versus general exercise treatment on disability in patients with LBP and MCI. In a multicentre parallel group randomised controlled pragmatic trial, patients with sub-acute and chronic LBP were included. Further inclusion criteria were disability of ≥5 points on the Roland-Morris Disability Questionnaire and ≥2 positive tests out of a set of 6 movement control impairment tests. A total of 106 patients were randomly assigned to either tailored movement control exercise intervention (MC, n=52) or a general exercise intervention (GE, n=54); both 9-18 individual treatment sessions, over a maximum of 12 weeks. The primary outcome was disability measured with the Patient Specific Functional scale (PSFS). Secondary outcome was the Roland-Morris disability scale (RMDQ). Measurements were taken pre- and posttreatment. No significant difference was found following the treatment period. Baseline-adjusted between-group mean difference for the PSFS was 0.5 (SD=0.5; p=0.32) in favour of MC exercises. The Roland-Morris Disability Questionnaire revealed a significant, but not clinically relevant, between-group difference of 2.0 points (SD=0.8; p=0.01). Disability in LBP patients was reduced considerably by both interventions. However, the limited contrast between the two exercise programs may have influenced outcomes.

Locomotive biomechanics in persons with chronic ankle instability and lateral ankle sprain copers.

To compare the locomotive biomechanics of participants with chronic ankle instability (CAI) to those of lateral ankle sprain (LAS) copers. Cross-sectional study. Twenty-eight participants with CAI and 42 LAS copers each performed 5 self-selected paced gait trials. 3-D lower extremity temporal kinematic and kinetic data were collected for these participants from 200ms pre- to 200ms post-heel strike (period 1) and from 200ms pre- to 200ms post-toe off (period 2). The CAI group displayed increased hip flexion bilaterally during period 1 compared to LAS copers. During period 2, CAI participants exhibited reduced hip extension bilaterally, increased knee flexion bilaterally and increased ankle inversion on the 'involved' limb. They also displayed a bilateral decrease in the flexor moment pattern at the knee. Considering that all of the features which distinguished CAI participants from LAS copers were also evident in our previously published research (within 2-weeks following acute first-time LAS); these findings establish a potential link between these features and long-term outcome following first-time LAS. Clinicians must be cognizant of the capacity for these movement and motor control impairments to cascade proximally from the injured joint up the kinetic chain and recognise the value that gait re-training may have in rehabilitation planning to prevent CAI.

Summary score or individual items: ten movement control impairment tests for the neck

extension (sensitivity 33.33%, specificity 96.67%), 0.63 for the protraction–retraction of the head (sensitivity 36.67%, specificity 90.00%) and 0.73 for the quadruped cervical rotation (sensitivity 70.00%, specificity 76.67%). The combination of the three tests reached an excellent AUC value of 0.83 (sensitivity 86.67%and specificity 63.33%with a cut-off of at least one test positive). The calculation of a probability score would yield even better results (AUC of 0.85; sensitivity 83.33% and specificity 73.33% at a cut-off of ≥61% probability). All shown values were statistically significant at a 5% significance level. Conclusion(s): Of the ten tests, the cervico-thoracic extension test, the protraction-retraction of the head test and the quadruped cervical rotation test had the best discriminative validity. Implications: We recommend the use of the cervicothoracic extension test, the protraction–retraction of the head test and the quadruped cervical rotation test for the detection of movement control impairments in patients with neck pain.

Test-retest reliability of lumbar movement control tests in patients with chronic non-specific low back pain

Background: Low back pain (LBP) is a highly prevalent and costly musculoskeletal syndrome. In recent years, movement control impairments in patients with chronic LBP have been documented and may be identified through movement control tests in clinical settings. However, only few studies were found to evaluate the reliability of these movement control tests. More studies are needed to standardize the testing procedures and to investigate the reliability of the movement control tests in patients with lumbar spine disorders.

Chest physiotherapy for pneumonia in children: a systematic review

(week 16). The Foundation Matrix is a battery of 10 multijoint functionally relevant Movement Control Tests used to evaluate movement efficiency and identify uncontrolled movement (UCM). The system reports the site (e.g. hip), direction (e.g. flexion) and threshold (low or high) of UCM. Low threshold refers to non-fatiguing, alignment and coordination impairments, and high threshold refers to strength and speed impairments The objective of this assessment tool is to inform the development of a specific retraining programme. The impaired movement control and uncontrolled movement was targeted in a tailored 16-week cognitive movement control retraining programme. The Faculty of Health Sciences, University of Southampton Ethics Committee, approved the study. Results: There was an increase in score for all 6 subscales of HAGOS: symptoms (61/100 pre, 96/100 post); pain (53/100 pre, 93/100 post); physical function (65/100 pre, 100/100 post); sport (56/100 pre, 100/100 post); physical activities (13/100 pre, 75/100 post); quality of life (32/100 pre, 85/100 post). Hip ROM improved for both passive (pre 78 degrees, post 116 degrees) and active movement (98 to 118 degrees). Workload increased from 4 to 18 hours a week. The Foundation Matrix score improved from 25/50 to 9/50 UCM impairments, percentage improvement ofUCMs at low threshold from 53% to 21% and high threshold 50% to 28%. Conclusion(s): A 16-week movement control retraining programme improved symptoms, activity limitations, participation restrictions and quality of life in an elite rower with persistent hip pain. Implications: This case study demonstrates proof of concept ofmovement control retraining as a potentially effective approach for the management of hip pain that has not responded to surgery for FAI and has implications for patients with symptoms associated with FAI.

Correlation between lumbar dysfunction and fat infiltration in lumbar multifidus muscles in patients with low back pain

Lumbar multifidus muscles (LMM) are important for spinal motion and stability. Low back pain (LBP) is often associated with fat infiltration in LMM. An increasing fat infiltration of LMM may lead to lumbar dysfunction. The purpose of this study was to investigate whether there is a correlation between the severity of lumbar dysfunction and the severity of fat infiltration of LMM. In a cross-sectional study, 42 patients with acute or chronic LBP were recruited. Their MRI findings were visually rated and graded using three criteria for fat accumulation in LMM: Grade 0 (0–10%), Grade 1 (10–50%) and Grade 2 (>50%). Lumbar sagittal range of motion, dynamic upright and seated posture control, sagittal movement control, body awareness and self-assessed functional disability were measured to determine the patients’ low back dysfunction. The main result of this study was that increased severity of fat infiltration in the lumbar multifidus muscles correlated significantly with decreased range of motion of lumbar flexion (p = 0.032). No significant correlation was found between the severity of fat infiltration in LMM and impaired movement control, posture control, body awareness or self-assessed functional disability. This is the first study investigating the relationship between the severity of fat infiltration in LMM and the severity of lumbar dysfunction. The results of this study will contribute to the understanding of the mechanisms leading to fat infiltration of LMM and its relation to spinal function. Further studies should investigate whether specific treatment strategies are effective in reducing or preventing fat infiltration of LMM.

Three promising tests for the detection of movement control impairment in the neck; analysis of discriminative validity

Three promising tests for the detection of movement control impairment in the neck; analysis of discriminative validity

Optimal cut-off score for movement control impairment tests

Optimal cut-off score for movement control impairment tests

Movement control exercise versus general exercise to reduce disability in patients with low back pain: randomized controlled multicentre study

Purpose: To assess the optimal cut-off for of a summary score of six movement control impairments tests. Methods: Subjects were 1180 patients with back pain and 102 healthy subjects without back pain. Design:A cross sectional study with cases and controls to find out the best cut off point score or the best test combination for discriminative validity between patients with back pain and healthy controls. Statistical analyses: Diagnostic odds ratios, sensitivity and specificity for the different cutoffs as well as area under the curve values were calculated with logistic regressions with corresponding 95% confidence intervals. Results: The optimal cut-off was with two or more positive movement control impairment tests out of six, resulting in a diagnostic odds ratio of 8.04 (95%CI 4.30 to 15.06 and a sensitivity of 68% and a specificity of 79%. If analysed individually, the test with the best discriminative validity was the prone knee bend (AUC0.67; OR 5.58, sensitivity 51%, specificity 84%), followed by four point kneeling (AUC 0.65, OR 3.7, sensitivity 52%, specificity 77%; and waiters bow (AUC 0.62, OR 4.6, sensitivity 33% and specificity 90%). Conclusion(s): The optimal cut-off for discriminating patients with back pain from healthy controls was with two or more positive movement control impairment tests out of six, resulting in a diagnostic odds ratio of 8.04. Implications: It is recommendable to use the whole test battery of six tests tpoevaluate the movement control ability of the subjects. If two or more tests are positive, the Odds are 6 to 1 that this person has back pain.

Inter- and intra-observer reliability of three movement control tests for the lumbo-pelvic complex

Background: Impaired movement control of the lumbo-pelvic complex has been proposed as a cause of non-specific low-back pain (NSLBP). Studies report improvements in pain and function following rehabilitation comprising motor control exercises. Reliable and valid tests designed to discern weak links in a kinetic chain are of importance for optimal rehabilitation.

Trunk motor control deficits in acute and subacute low back pain are not associated with pain or fear of movement

Background contextA subgroup of patients with acute to subacute low back pain (LBP) presenting with trunk movement control deficits, pain provocation with segmental testing, and segmental hypermobility have been clinically identified as having movement coordination impairments (MCIs) of the trunk. It is hypothesized that these patients have proprioceptive, postural, and movement control impairments of the trunk associated with LBP. Although trunk control impairments have been identified in patients with chronic LBP, they have not been investigated in this subgroup or closer to symptom onset. PurposeThe purpose of the study was to identify trunk motor control (postural control and movement precision) impairments in a subgroup of patients with acute to subacute LBP who have been clinically identified to have MCIs and determine association of these impairments with pain and fear of movement. Study design/settingThe study design includes observational design, university biomechanics laboratory, and clinical practice. Patient sampleThirty-three patients with acute to subacute LBP presenting with trunk MCIs and 33 healthy controls matched with gender, age, and body mass index were identified. Outcome measuresSelf-report measures included Numeric Pain Rating Scale, Oswestry Disability Index Questionnaire, and Fear-Avoidance Beliefs Questionnaire and physiologic measures included postural control and movement precision. MethodsCenter-of-pressure movement was measured while subjects attempted to volitionally control trunk posture and movement while sitting on a platform with a hemisphere mounted underneath. This created an unstable surface that required coordinated trunk control to maintain an upright seated posture. Postural control was tested using eyes-open and -closed balance protocols. Movement precision was tested with a dynamic control test requiring movement of the center of pressure along a discrete path. Group trunk motor control performance was compared with analysis of variance and t test. Performance association with pain and fear of movement were assessed with Pearson correlations. ResultsPatients’ postural control in the eyes-closed condition (p=.02) and movement precision (p=.04) were significantly impaired compared with healthy controls, with moderate-to-large group difference effect sizes. These trunk motor control impairments were not significantly associated with the patients self-reported pain characteristics and fear of movement. ConclusionsPatients with clinical identification of trunk MCIs demonstrated decreased trunk motor control, suggesting that impairments in proprioception, motor output, or central processing occur early in the back pain episode. This information may help to guide interventions to address these specific limitations, improving delivery of care.

A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: A randomised controlled trial with one-year follow-up

BackgroundExercise is an effective treatment for patients with sub-acute and chronic non-specific low back pain (NSLBP). Previous studies have shown that a subgroup of patients with NSLBP and movement control impairment (MCI) can be diagnosed with substantial reliability. However, which type of exercises are most beneficial to this subgroup is still unknown. ObjectivesThe effectiveness of a specific exercise treatment to improve movement control was tested in this study. MethodsUsing a multicentre randomised controlled trial (RCT), we compared exercises that targeted MCI (MC) with a general exercise (GE) treatment. After randomisation, patients in both groups n(MC = 52; GE = 54) were treated in eight private physiotherapy practices and five hospital outpatient physiotherapy centres. Follow-up measurements were taken at post-treatment, six months and 12 months. The primary outcome measurement was the Patient Specific Function Scale (PSFS). ResultsPSFS showed no difference between groups after treatment, or at six months and 12 months. Secondary outcome analysis for pain and disability, measured with the Graded Chronic Pain scale and the Roland Morris Disability Questionnaire respectively, showed that a small improvement post-treatment levelled off over the long term. Both groups improved significantly (p < 0.001) over the course of one year. ConclusionThis study found no additional benefit of specific exercises targeting MCI.

The effect of motor control and tactile acuity training on patients with non-specific low back pain and movement control impairment

Movement control impairment is a clinical subgroup of non-specific low back pain which can be assessed reliably. There is a strong correlation between tactile acuity and movement control suggesting these two treatments might have additive effects. The first research aim was to determine if patients with a motor control impairment demonstrated improvement in outcome with combined tactile acuity and motor control training. The second aim was to determine if tactile acuity training enhanced the effect of motor control training. The primary study was a single-arm cohort study conducted in three physiotherapy practices in the German-speaking part of Switzerland. 40 patients (23 males and 17 females) suffering from non-specific low back pain (NSLBP) and movement control impairment were treated. Patients were assessed at baseline and immediately post treatment. Treatment included exercises to lumbopelvic control and graphesthesia training to improve tactile acuity. Treatment effects were evaluated using the Roland Morris disability questionnaire (RMQ) and the patient-specific functional scale (PSFS). The performance on a set of six movement control tests and lumbar two-point discrimination were also assessed. The results of this cohort study were compared with a historic control group which was comparable with the primary study but included only motor control exercises. All the outcomes improved significantly with the combined training (RMQ - 2.2 pts., PSFS - 2.8 pts.; MCTB - 2.02 pts. & TPD - 17.07 mm; all p < 0.05). In comparison to the outcomes of the historic control, there was no significant differences in movement control, patient-specific functional complaints or disability between the groups. The results of this study, based on a before and after intervention comparison, showed that outcome improved significantly following combined tactile acuity and motor control training. However, compared to an earlier study, the tactile acuity training did not have an additional effect to the results. The use of historical controls does not control for allocation bias and the results obtained here require verification in a randomized controlled trial.

Reliability of Musculoskeletal Fitness Tests and Movement Control Impairment Test Battery in Female Health-Care Personnel with Re-Current Low Back Pain

Background: Low back pain (LBP) is one of the most important causes of work absenteeism in health-care personnel. Low performance levels for fitness components, and movement control impairment (MCI) of the spine have been posited to be risk factors for persistent LBP. The aims of this study were to examine the long-term reliability (test I – test II) of selected motor and musculoskeletal fitness tests and the standard MCI test battery in female health-care personnel with nonspecific LBP, and to investigate associations between change in intensity of LBP and variation in test results in two measurement points. Methods: The participants (n=47) were workers in geriatric wards. Long-term reliability of six field tests assessing motor abilities, flexibility and muscular strength, and the MCI test battery were studied. Mean test I – test II time-span was 18 days (SD 7.9). The estimates of reliability for interval-scale measurements (fitness) were typical error (s) of measurement and the coefficient of variation (CV). The reliability of nominal-scale measurements was analysed by the kappa coefficient. Results: The lowest within-subject variation was found in running figure of eight test (s=0.22 s, CV=2.8%) and the highest for modified push-ups (s=1.04 repetitions, CV=12.2%). The kappa values for the dorsal pelvic tilt, sitting knee extension, the anterior pelvic tilt, and lying-prone knee flexion varied between 0.71 and 0.45 but were lower for rocking forwards and backwards (k=0.31) and the one-leg stance (k=0.16). Change in the pain intensity was associated only with variation in test I – test II results for modified push-ups (p=0.045). Conclusions: All of the tests assessing musculoskeletal fitness and four of the MCI tests had an acceptable level of long-term reliability. The two tests for MCI that had poor reliability need to be better standardised in order to serve as reliable clinical measurement tools.

Reliability of movement control tests on the cervical spine

BackgroundMovement control impairment reduces active control of movement. Patients with this might form an important subgroup among patients with mechanical cervical pain. Diagnosis is based on the observation of active movement tests. Although widely used clinically, few studies have been performed to determine the reliability of a test battery. The aim of this study was to determine the inter-tester reliability of movement control impairment [MCI] tests on the cervical spine.MethodsForty-five subjects (31 patients with neck pain, 14 healthy controls) were videotaped while performing a standardized test battery consisting of 13 tests of active movement control. Using observation, two experienced physiotherapists independently rated test performances as correct or incorrect. One of them was blinded to all other patient information and both to each other. Kappa coefficients and 95% confidence intervals [CI] for inter-tester results were calculated.ResultsThe kappa values for inter-tester reliability ranged in from 0.47-1.0 of the 13 tests, 2 demonstrated perfect reliability (k = 1.0), 4 excellent (k 0.81-0.99), 6 substantial (k 0.61-0.8) and 1 good (k 0.41-0.6).ConclusionsThe physiotherapists were able reliably rate the majority the tests in this series of motor control tasks. There have been studies performed describing the assessment and treatment of movement control impairment problems and low back pain. However, no study has involved the assessment of the cervical dysfunction subgroup. This study presents a reliable test battery, for clinical use, to perform more specific examination of this subgroup.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-402) contains supplementary material, which is available to authorized users.