scholarly journals Concurrent validity and reliability of measuring range of motion during the cervical flexion rotation test with a novel digital goniometer

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kerstin Luedtke ◽  
Thomas Schoettker-Königer ◽  
Toby Hall ◽  
Christine Reimer ◽  
Maike Grassold ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Range Of Motion ◽  
Head And Neck ◽  
Concurrent Validity ◽  
Reliability And Validity ◽  
Upper Cervical Spine ◽  
Rater Reliability ◽  
Rotation Test ◽  
Upper Cervical

Abstract Background Headache is a common and costly health problem. Although the pathogenesis of headache is heterogeneous, reported contributing factors are dysfunctions of the upper cervical spine. The flexion rotation test (FRT) is a commonly used diagnostic test to detect upper cervical movement impairment. A digital goniometer may support precise measurement of movement impairment in the upper cervical spine. However, its reliability and validity is not assessed, yet. The aim of this study was to investigate the reliability and validity of the digital goniometer compared to an ultrasound-based movement analysis system. Methods Two separate cross-sectional studies were conducted using the digital goniometer EasyAngle (Meloq AB, Stockholm, Sweden) for a) investigating the concurrent validity of upper cervical range of motion (ROM) during the FRT and b) determining the inter- and intra-rater reliability in the target population of patients with head and neck pain. Sixty-two participants, 39 with and 23 without head and neck pain, were recruited for the concurrent validity study. For the reliability study, a total of 50 participants were recruited. Intraclass correlation coefficients (ICC) and Bland Altmann plots were used to assess validity and ICC values, Bland Altmann plots as well as Kappa coefficients were used for estimating intra-rater and inter-rater reliability. Results Concurrent validity was strong with an ICC (2,1) of 0.97 for ROM to either side (95%CI = 0.95–0.98). Bland Altman Plots revealed a mean difference between measurement systems of 0.5° for the left and 0.11° for the right side. The inter-rater ICC (2,1) was 0.66 (95%CI 0.47–0.79, p <  0.001, SEM 6.6°), indicating good reliability. The limits of agreement were between 10.25° and − 11.89°, the mean difference between both raters was − 0.82°. Intra-rater reliability for the measurement of ROM during the FRT was between 0.96 (ICC 3,1) for rater 1 and 0.94 (ICC 3,1) for rater 2. Conclusions The digital goniometer demonstrated strong concurrent validity and good to strong reliability and can be used in clinical practice to accurately determine movement impairment in the upper cervical spine. Trial registration German Registry of Clinical Trials DRKS00013051.

scholarly journals Does the Addition of Manual Therapy Approach to a Cervical Exercise Program Improve Clinical Outcomes for Patients with Chronic Neck Pain in Short- and Mid-Term? A Randomized Controlled Trial

2020 ◽  
Vol 17 (18) ◽  
pp. 6601 ◽  
Author(s):  
Jacobo Rodríguez-Sanz ◽  
Miguel Malo-Urriés ◽  
Jaime Corral-de-Toro ◽  
Carlos López-de-Celis ◽  
María Orosia Lucha-López ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Manual Therapy ◽  
Exercise Program ◽  
Chronic Neck Pain ◽  
Exercise Group ◽  
Home Exercise ◽  
Upper Cervical Spine ◽  
Upper Cervical ◽  
Cervical Spine Dysfunction

Chronic neck pain is one of today’s most prevalent pathologies. The International Classification of Diseases categorizes four subgroups based on patients’ associated symptoms. However, this classification does not encompass upper cervical spine dysfunction. The aim is to compare the short- and mid-term effectiveness of adding a manual therapy approach to a cervical exercise protocol in patients with chronic neck pain and upper cervical spine dysfunction. Fifty-eight subjects with chronic neck pain and upper cervical spine dysfunction were recruited (29 = Manual therapy + Exercise; 29 = Exercise). Each group received four 20-min sessions, one per week during four consecutive weeks, and a home exercise regime. Upper flexion and flexion-rotation test range of motion, neck disability index, craniocervical flexion test, visual analogue scale, pressure pain threshold, global rating of change scale, and adherence to self-treatment were assessed at the beginning, end of the intervention and at 3- and 6-month follow-ups. The Manual therapy + Exercise group statistically improved short- and medium-term in all variables compared to the Exercise group. Four 20-min sessions of Manual therapy + Exercise along with a home-exercise program is more effective in the short- to mid-term than an exercise protocol and a home-exercise program for patients with chronic neck pain and upper cervical dysfunction.

scholarly journals Normal kinematics of the upper cervical spine during the Flexion–Rotation Test – In vivo measurements using magnetic resonance imaging

2011 ◽  
Vol 16 (2) ◽  
pp. 167-171 ◽  
Author(s):  
Hiroshi Takasaki ◽  
Toby Hall ◽  
Sadanori Oshiro ◽  
Shouta Kaneko ◽  
Yoshikazu Ikemoto ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Upper Cervical Spine ◽  
Resonance Imaging ◽  
Rotation Test ◽  
In Vivo Measurements ◽  
Upper Cervical

scholarly journals Neck Pain Following Concussion

Concussion ◽  
2019 ◽  
pp. 151-154
Author(s):  
Brian Hainline ◽  
Lindsey J. Gurin ◽  
Daniel M. Torres
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Cervical Spine Injury ◽  
Cervicogenic Headache ◽  
Spine Injury ◽  
Upper Cervical Spine ◽  
Persistent Symptoms ◽  
Upper Cervical ◽  
Vestibular Symptoms ◽  
Serious Injury

Neck pain and cervicalgia are common following concussion. The cervical spine should be carefully examined in any individual who has sustained a concussion, because neck pain may be a sign of more serious underlying cervical spine injury. Even when a more serious injury has been ruled out, it is noteworthy that the cervical structures are vulnerable to stress and injury at their end range of motion, and such motion occurs commonly in an accelerated fashion with concussion. Further, cervical spine injury may cause faulty proprioceptive input from the upper cervical spine, resulting in vestibular symptoms. Cervicalgia is a source of persistent symptoms following concussion and frequently manifests with dizziness and cervicogenic headache. Individuals with persistent symptoms of cervicalgia or cervicogenic headache may benefit from a combination of physical therapy and vestibular therapy.

scholarly journals Does isolated atlantoaxial fusion result in better clinical outcome compared to occipitocervical fusion?

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Katharina E. Wenning ◽  
Martin F. Hoffmann
Keyword(s):  
Cervical Spine ◽  
Clinical Outcome ◽  
Range Of Motion ◽  
Rating Scale ◽  
Neck Disability Index ◽  
Upper Cervical Spine ◽  
Occipitocervical Fusion ◽  
Atlantoaxial Fusion ◽  
Upper Cervical

Abstract Background The C0 to C2 region is the keystone for range of motion in the upper cervical spine. Posterior procedures usually include a fusion of at least one segment. Atlantoaxial fusion (AAF) only inhibits any motion in the C1/C2 segment whereas occipitocervical fusion (OCF) additionally interferes with the C0/C1 segment. The purpose of our study was to investigate clinical outcome of patients that underwent OCF or AAF for upper cervical spine injuries. Methods Over a 5-year period (2010–2015), consecutive patients with upper cervical spine disorders were retrospectively identified as having been treated with OCF or AAF. The Numeric Pain Rating Scale (NPRS) and the Neck Disability Index (NDI) were used to evaluate postoperative neck pain and health restrictions. Demographics, follow-up, and clinical outcome parameters were evaluated. Infection, hematoma, screw malpositioning, and deaths were used as complication variables. Follow-up was at least 6 months postoperatively. Results Ninety-six patients (male = 42, female = 54) underwent stabilization of the upper cervical spine. OCF was performed in 44 patients (45.8%), and 52 patients (54.2%) were treated with AAF. Patients with OCF were diagnosed with more comorbidities (p = 0.01). Follow-up was shorter in the OCF group compared to the AAF group (6.3 months and 14.3 months; p = 0.01). No differences were found related to infection (OCF 4.5%; AAF 7.7%) and revision rate (OCF 13.6%; AAF 17.3%; p > 0.05). Regarding bother and disability, no differences were discovered utilizing the NDI score (AAF 21.4%; OCF 37.4%; p > 0.05). A reduction of disability measured by the NDI was observed with greater follow-up for all patients (p = 0.01). Conclusion Theoretically, AAF provides greater range of motion by preserving the C0/C1 motion segment resulting in less disability. The current study did not show any significant differences regarding clinical outcome measured by the NDI compared to OCF. No differences were found regarding complication and infection rates in both groups. Both techniques provide a stable treatment with comparable clinical outcome.

scholarly journals Extension and flexion in the upper cervical spine in neck pain patients

2015 ◽  
Vol 20 (4) ◽  
pp. 547-552 ◽  
Author(s):  
Markus J. Ernst ◽  
Rebecca J. Crawford ◽  
Sarah Schelldorfer ◽  
Anne-Kathrin Rausch-Osthoff ◽  
Marco Barbero ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Upper Cervical Spine ◽  
Upper Cervical ◽  
Pain Patients
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