Reliability of functional findings

Introduction

Chronic tension headache is a common medical problem. Many patients present to manual medicine specialists. Scientific data regarding the relevance of somatic dysfunction for the pathogenesis of chronic tension headache are inconsistent. In order to address this issue, a study protocol was developed. In the present study, the first two steps of the protocol were undertaken.

Material and methods

In order to identify valuable functional findings and tests, the first step of the study was a Delphi process. The second step consisted of testing the inter-rater reliability of the suggested tests.

Results

In total, 38 different clinical tests were identified to be relevant for chronic tension headache. Inter-rater reliability was reasonable for somatic dysfunction of the cervical spine, as was the test for muscular tension of the trapezius muscle. None of the other tests were found to be sufficiently reliable.

Conclusion

We could show that a subset of tests assumed to be relevant for chronic tension headache are reliable. The other tests have to be refined or the study protocol has to adapted to obtain an even distribution of positive/negative findings.