Reliability and diagnostic accuracy of clinical special tests for myelopathy in patients seen for cervical dysfunction

Cook C, Roman M, Stewart KM, Leithe LG, Isaacs R

The objective of this study was to determine the reliability and diagnostic accuracy of neurological tests associated with the diagnosis of myelopathy. Reliability and diagnostic accuracy of 7 frequently used tests and measures and subjective findings associated with myelopathy were examined on consecutive patients with cervical pain. Interrater reliability and diagnostic accuracy values, including posttest probability, based on a pretest probability of 40%, were calculated for each test and for combinations of tests and measures.

This study demonstrated that 4 of 7 tests used to screen for myelopathy offered substantial levels of interrater agreement when used on individuals with cervical dysfunction. None of the tests when performed individually or in combinations are effective for screening; however, the Babinski sign did alter posttest probability more significantly than combinations of test findings.

J Orthop Sports Phys Ther. 2009, 39(3), 172-8

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