The inter-rater and intra-rater reliability for measures of passive rotation of the cervical spine with a big protractor. A pre-study with a doll before performing the study with infants

Infants with congenital muscular torticollis (CMT) often have some degree of limited rotation in the cervical spine toward the affected side. Measurement of passive range of motion (PROM) is an essential part of the examination. The aim of this study was to look for inter-rater and intra-rater reliability for measures of PROM in cervical rotation with a big protractor. Method: Three physical therapists (PT) and one pediatric nurse participated in the evaluation of intra-rater and inter-rater reliability for PROM measurements of cervical rotation with a protractor. Three dolls were used instead of infants to exclude an unwillingness in infants that likely would restrain repeated measurements. The study was carried out in two parts, part I with a doll in real time and part II with photographs of three dolls in different positions. Results: Both the intra-rater and inter-rater intraclass correlation coefficient (ICC) was >0.9. Inter-rater reliability was high for both the experienced and less experienced evaluators, it was however highest for the more experienced PT. Conclusion: The reliability of measuring passive cervical rotation with a protractor was high in both intra-rater and inter-rater measurements regardless of short or long experience as a PT.