Normative Scores and Test-Retest Reliability of Neck Strength, Endurance, and Proprioception Tests in Children and Adolescents

OBJECTIVE: To determine normative scores, test-retest reliability, and minimal detectable change for the neck flexor endurance test (NFET), craniocervical flexion test (CCFT), and joint position error test (JPET) in children. DESIGN: Cross-sectional. METHODS: Two hundred typically developing children (10-15 years) were recruited. Participants were screened for cervical spine instability using the alar and transverse ligament tests prior to administering the NFET, CCFT, and JPET. Testing was performed twice on the same day, 6 hours apart. RESULTS: For the younger age group, average NFET scores were as follows: females = 9.1 seconds, males = 10.1 seconds. Mean CCFT scores decreased with an increase in pressure (22 millimeters of mercury [mmHg]: females = 6.1 seconds [1], males = 6.8 seconds [1]; 30 mmHg: females = 4.07 seconds [1.1], males = 4.1 seconds [0.9]). For the CCFT, reliability reduced as pressure increased. The JPET had moderate reliability (ICC 2, k = 0.4-0.63) with the highest error in right rotation (females = 14.1 cm [5], males = 13.4 cm [4.7]). The NFET had excellent reliability (ICC 2, k = 0.96 [0.94-0.97], P<.001). CONCLUSION: The normative scores presented serve as a reference standard for future studies and for systematic screening and head and neck injury prevention. JOSPT Open 2024;2(4):1-6. Epub 20 May 2024. doi:10.2519/josptopen.2024.1135