Objective Measurements of Neck Function. A Critical Review of their Validity and Reliability

Neck pain and headache are very common symptoms, especially in western societies. Clinical research is often confounded by the multiplicity of aetiological factors and is usually based on subjective assessment of these symptoms. A comprehensive clinical evaluation of the cervical spine should include both subjective and objective assessment. Quantification of neck function requires evaluation of all parameters, including range of motion, strength, endurance and proprioception. Recently, there has been increased effort towards reliability and validity studies concerning mainly the cervical range of motion and strength. Neck endurance and proprioception have been investigated, but to a smaller extent. A review of the literature has revealed the lack of reliable and valid instruments, as well as flaws regarding the methodologies and statistical techniques of the studies. Thus, further research is needed to establish 'gold standards' with the most appropriate protocols.