Reliability of a Musculoskeletal Assessment for the Examination of Cervical Spine Pain and Injuries in Special Forces Combat Soldiers

An assessment of protocol reliability is an essential step prior to human subject testing for injury prevention. The purpose of this study was to examine the inter-rater and intra-rater reliability of a portable cervical range of motion and isometric strength protocol designed for special forces combat soldiers who are at risk for cervical spine pain and injury due to exposure to head-supported mass. Eight individuals were tested three times to assess reliability, the standard error of the measurement (SEM), and the minimal detectable change across six range of motion measures and six strength measures of the cervical spine. One tester tested all participants twice for intra-rater reliability, and a second tester assessed the participants to examine inter-tester reliability. All reliability measures demonstrated good to excellent reliability (ICC = 0.70–0.96 (isometric strength); ICC = 0.85–0.94 (range of motion)). All SEM scores were 12% or lower for all reliability measures. The findings of this study demonstrate that the protocol developed for a longitudinal multi-site study is reliable and appropriate to implement for injury prevention in military personnel.