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Intrarater and Inter-rater Reliability of Maximal Voluntary Neck Muscle Strength Assessment Using a Handheld Dynamometer in Women With Headache and Healthy Women.

OBJECTIVE: This study aimed to determine the inter-rater and intrarater reliability, agreement, and minimal detectable change (MDC) of the neck muscle strength test using a handheld dynamometer in healthy women and women with headaches.

METHODS: Neck muscle strength in maximal voluntary contraction was measured using the Lafayette Manual Muscle Testing attached to a nonelastic belt in 25 women with migraines and in 25 healthy women. Three repetitions of flexion, extension, and lateral flexion were performed. The tests were performed by 2 examiners on the same day, with a 10-minute interval, and by 1 examiner, with a 1-week interval. The reliability was verified by the intraclass correlation coefficient, the agreement determined by standard error measurement, and the MDC calculated.

RESULTS: The protocol exhibited moderate to excellent intrarater and inter-rater reliabilities in both groups (intraclass correlation coefficientrange , 0.53-0.90). The standard error measurement ranged from 0.43 to 1.81 and the MDC from 1.49 up to 4.61.

CONCLUSION: Quantification of neck muscle strength using the handheld dynamometer with an attached nonelastic belt exhibited moderate to excellent intra- and inter-rater reliability in women with and without migraines. Moreover, the standard error measurement and MDC were proven to be useful in the interpretation of data and in guiding clinical decisions.

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