CORRELATION BETWEEN CERVICAL MORPHOLOGY, PAIN, FUNCTIONALITY, AND ROM IN INDIVIDUALS WITH CERVICALGIA

ABSTRACT Objective: To verify if there is a correlation between the morphology of the cervical spine curvature, pain intensity, functional disability, and range of motion in individuals with cervicalgia. Methods: Thirty-nine individuals were evaluated using x-rays in the right sagittal plane (Cobb C1-C7 two-line method), visual analogue scale, Neck Disability Index questionnaire, and fleximeter. Descriptive statistical analysis (percentage, mean and standard deviation) and inferential (independent t-test and Pearson product-moment correlation coefficient, α=0.05) were performed. Results: There were significant correlations, ranging from moderate to high, between functional capacity and pain intensity (r=0.637, p<0.001), and total range of motion (r=-0.568, p<0.001), and extension (r=-0.610, p<0.001), and between pain intensity and range of motion (r=-0.422, p=0.007). Regarding the morphology of the cervical spine curvature, none of the variables showed a significant correlation. Conclusions: Cervical morphology, more specifically related to the curvature in the sagittal plane, does not seem to interfere alone with pain, functionality, and range of motion. In contrast, it is possible to affirm that higher levels of pain generate a smaller range of cervical movement, especially of extension, which, in turn, results in greater functional losses in individuals with neck pain. Level of Evidence II; Prognostic Studies - Investigating the Effect of a Patient Characteristic on the Outcome of Disease.

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The influence of fixed sagittal plane centers of rotation on motion segment mechanics and range of motion in the cervical spine

Journal of Biomechanics ◽

10.1016/j.jbiomech.2013.01.018 ◽

2013 ◽

Vol 46 (7) ◽

pp. 1369-1375 ◽

Cited By ~ 4

Author(s):

Brian P. Kelly ◽

Nephi A. Zufelt ◽

Elizabeth J. Sander ◽

Denis J. DiAngelo

Keyword(s):

Cervical Spine ◽

Range Of Motion ◽

Sagittal Plane ◽

Motion Segment

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A Novel Technique to Assess Rotational Deformities in Lower Extremities

10.21203/rs.3.rs-115250/v1 ◽

2020 ◽

Author(s):

Peyman Bakhshayesh ◽

Ugwunna Ihediwa ◽

Sukha Sandher ◽

Alexandros Vris ◽

Nima Heidari ◽

...

Keyword(s):

Moving Objects ◽

Sagittal Plane ◽

Three Dimensional ◽

Contralateral Side ◽

Ct Images ◽

New Technique ◽

X Rays ◽

Digital Technique ◽

The Right ◽

Im Nailing

Abstract Introduction: Rotational deformities following IM nailing of tibia has a reported incidence of as high as 20%. Common techniques to measure deformities following IM nailing of tibia are either based on clinical assessment, plain X-rays or CT-scan comparing the treated leg with the uninjured contralateral side. All these techniques are based on examiners manual calculation inherently subject to bias. Following our previous rigorous motion analysis and symmetry studies on hemi pelvises, femurs and orthopaedic implants, we aimed to introduce a novel fully digital technique to measure rotational deformities in the lower legs.Material and Methods: Following formal institutional approval from the Imperial College, CT images of 10 pairs of human lower legs were retrieved. Images were anonymized and uploaded to a research server. Three dimensional CT images of the lower legs were bilaterally reconstructed. The mirrored images of the left side were merged with the right side proximally as stationary and distally as moving objects. Discrepancies in translation and rotation were automatically calculated.Results: Our study population had a mean age of 54 ± 20 years. There were six males and four females. We observed a greater variation in translation (mm) of Centre of Mass (COM) in sagittal plane (CI: -2.959--.292) which was also presented as rotational difference alongside the antero-posterior direction or Y axis (CI: .370-1.035). In other word the right lower legs in our study were more likely to be in varus compared to the left side. However, there were no statistically significant differences in coronal or axial planes.Conclusion: Using our proposed fully digital technique we found that lower legs of the human adults were symmetrical in axial and coronal plane. We found sagittal plane differences which need further addressing in future using bigger sample size. Our novel recommended technique is fully digital and commercially available. This new technique can be useful in clinical practice addressing rotational deformities following orthopaedic surgical intervention. This new technique can substitute the previously introduced techniques.

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Effectiveness of Neural Mobilization on Pain, Range of motion, and Disability in Cervical Radiculopathy: a Randomized Controlled Trial

10.21203/rs.3.rs-223383/v1 ◽

2021 ◽

Author(s):

Shazia Rafiq ◽

Hamayun Zafar ◽

Prof. Dr. Syed Amir Gillani ◽

Muhammad Sharif Waqas ◽

Amna Zia ◽

...

Keyword(s):

Conservative Treatment ◽

Pain Intensity ◽

Range Of Motion ◽

Conventional Treatment ◽

Rating Scale ◽

Controlled Trial ◽

Neck Disability Index ◽

Sampling Technique ◽

Cervical Radiculopathy ◽

Neck Disability

Abstract Background: Cervical Radiculopathy (CR) is a disorder of the spinal nerve roots that is largely caused by space occupying lesion which can lead to nerve root inflammation and patient usually presents with radiating pain in his/her upper extremity known as cervical radiculopathy. The objective of the study was to compare the effectiveness of neural mobilization technique with conservative treatment on pain intensity, range of motion and disability.Methods: It was a double blinded randomized clinical trial; data was collected from Mayo Hospital, Lahore through convenience sampling technique. After taking consent from the patients, the patients fulfilling the inclusion and exclusion criteria were selected and randomized blindly and assigned through computer generated random number into two groups i.e. group 1 (neural mobilization), group 2 (conventional treatment). Pain intensity was measured on Numeric pain rating scale, range of motion measured with inclinometer and functional status with neck disability index (NDI). Data was analyzed using SPSS and difference in improvement before, after 02 and 04 weeks was noted and compared. Results: There was significant improvement in pain relief, neck disability and cervical ranges after the treatment in both groups compared to the pre-treatment status (p < 0.00) and when neural mobilization was compared , it was more effective technique than conventional treatment in reducing pain and neck disability (p < 0.00). But there was not statistical difference in mean score of cervical range of motion (p>0.05)Conclusions: The present study concluded that both neural mobilization and conservative treatment were effective as an exercise program for patient with cervical radiculopathy, however neural mobilization was more effective in reducing pain and neck disability in cervical radiculopathy.Trial registration: RCT20190325043109N1

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Cervical Spine Movement Sequencing During Flexion-Extension

ASME 2011 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2011-53694 ◽

2011 ◽

Author(s):

William J. Anderst ◽

Michelle Schafman ◽

William F. Donaldson ◽

Joon Y. Lee ◽

James D. Kang

Keyword(s):

Cervical Spine ◽

Range Of Motion ◽

Daily Living ◽

X Rays ◽

Clinical Tool ◽

Normal Range ◽

Kinematic Data ◽

Flexion Extension ◽

Functional Movements ◽

Spine Movement

Static flexion-extension x-rays are the most common clinical tool used to assess abnormal motion of the cervical spine. Despite their widespread use (over 168,000 cases per year), the clinical efficacy of flexion-extension radiographs of the cervical spine has yet to be proven1. Limitations of static flexion-extension x-rays include data collection during static positions that may not accurately represent dynamic behavior, and the fact that data is collected at end range of motion positions, not in more frequently encountered mid-range positions. Consequently, static x-rays may not reveal movement abnormalities that occur during activities of daily living and lead to pain and degeneration. Therefore, it may be advantageous to analyze cervical spine kinematic data collected during dynamic, functional movements performed through an entire range of motion (not just the endpoints). Furthermore, the literature confirms there is substantial variability in “normal” range of motion and translation during flexion-extension1, making it difficult to reliably identify abnormal motion. Therefore, it may also be beneficial to evaluate alternative motion parameters that may reliably identify abnormal motion.

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

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1525-y ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 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.

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Quantifying Cervical-Spine Curvature Using Bézier Splines

Journal of Biomechanical Engineering ◽

10.1115/1.4007749 ◽

2012 ◽

Vol 134 (11) ◽

Cited By ~ 3

Author(s):

Kathleen D. Klinich ◽

Sheila M. Ebert ◽

Matthew P. Reed

Keyword(s):

Cervical Spine ◽

Quantitative Method ◽

Advanced Technology ◽

Spinal Curvature ◽

Qualitative Assessment ◽

Spine Injury ◽

X Rays ◽

Gender And Age ◽

Spine Curvature ◽

Two Parameters

Knowledge of the distributions of cervical-spine curvature is needed for computational studies of cervical-spine injury in motor-vehicle crashes. Many methods of specifying spinal curvature have been proposed, but they often involve qualitative assessment or a large number of parameters. The objective of this study was to develop a quantitative method of characterizing cervical-spine curvature using a small number of parameters. 180 sagittal X-rays of subjects seated in automotive posture with their necks in neutral, flexed, and extended postures were collected in the early 1970s. Subjects were selected to represent a range of statures and ages for each gender. X-rays were reanalyzed using advanced technology and statistical methods. Coordinates of the posterior margins of the vertebral bodies and dens were digitized. Bézier splines were fit through the coordinates of these points. The interior control points that define the spline curvature were parameterized as a vector angle and length. By defining the length as a function of the angle, cervical-spine curvature was defined with just two parameters: superior and inferior Bézier angles. A classification scheme was derived to sort each curvature by magnitude and type of curvature (lordosis versus S-shaped versus kyphosis; inferior or superior location). Cervical-spine curvature in an automotive seated posture varies with gender and age but not stature. Average values of superior and inferior Bézier angles for cervical spines in flexion, neutral, and extension automotive postures are presented for each gender and age group. Use of Bézier splines fit through posterior margins offers a quantitative method of characterizing cervical-spine curvature using two parameters: superior and inferior Bézier angles.

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Impact of Cervical Spine Rehabilitation on Temporomandibular Joint Functioning in Patients with Idiopathic Neck Pain

BioMed Research International ◽

10.1155/2021/6886373 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Łukasz Oleksy ◽

Renata Kielnar ◽

Anna Mika ◽

Agnieszka Jankowicz-Szymańska ◽

Dorota Bylina ◽

...

Keyword(s):

Cervical Spine ◽

Neck Pain ◽

Pain Intensity ◽

Range Of Motion ◽

Temporomandibular Joint ◽

Clinical Condition ◽

Rehabilitation Programme ◽

Cervical Region ◽

Head Posture ◽

Tmj Pain

Objective. The aim of this study was to assess the effectiveness of a 3-week rehabilitation programme focusing only on the cervical region, pain intensity, range of motion in the cervical spine, head posture, and temporomandibular joint (TMJ) functioning in subjects with idiopathic neck pain who did not report TMJ pain. Design. A parallel group trial with follow-up. Methods. The study included 60 participants divided into 2 groups: experimental: n = 25 , 27-57 years old, experiencing idiopathic neck pain and who underwent a 3-week rehabilitation programme, and the control, n = 35 , 27-47 years, who were cervical pain-free. At baseline and after 3 weeks of treatment in the experimental group and with a 3-week time interval in the control group, pain intensity, head posture in the sagittal plane, range of motion in the cervical spine, and TMJ functioning were evaluated. Results. After 3 weeks of rehabilitation, there was a significant decrease in pain intensity, improved range of motion of the cervical spine and head posture, and improved clinical condition of TMJ in participants with idiopathic neck pain who did not report TMJ pain. Conclusion. The study suggested that idiopathic neck pain is associated with limited range of motion in the cervical spine, incorrect head posture, and TMJ dysfunction. Our data suggests that therapy focusing only on the cervical region may improve the clinical condition of the TMJ in subjects with idiopathic neck pain who do not report TMJ pain. These observations could be helpful in physiotherapeutic treatment of neck and craniofacial area dysfunctions. This trial is registered with ISRCTN Registry ISRCTN14511735.

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Effect of Cervical Mobilization, Transcutaneous Electrical Stimulation and Suboccipital Release in Cervicogenic Headache: A Case Report

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20210812 ◽

2021 ◽

Vol 11 (8) ◽

pp. 81-85

Author(s):

Darshana Fursule ◽

Kapil Garg

Keyword(s):

Case Report ◽

Cervical Spine ◽

Range Of Motion ◽

Rating Scale ◽

Neck Disability Index ◽

Cervicogenic Headache ◽

Pain Rating ◽

Numerical Pain Rating Scale ◽

Neck Disability ◽

Pain Rating Scale

Background: Cervicogenic headaches are one of the common musculoskeletal disorders that originates in the neck and are radiates from neck to head. Cervicogenic headache is usually treated with a comprehensive strategy that includes pharmacologic, nonpharmacologic, manipulative, anesthetic, surgical procedures and physiotherapy. Physiotherapy includes spinal manipulation, mobilization, myofascial release, exercises and electrotherapeutic modalities. Purpose: This case report aims to evaluate the effects of combination of cervical spine mobilization, TENS, Suboccipital release on cervicogenic headache in maintaining long-term benefits. Methods: This a case report of 31-year-old male having cervicogenic headache from 4-5 years. He reported symptoms like pain in right side neck which radiates into head till forehead and stiffness in neck. Physiotherapy treatment like cervical spine mobilization, TENS and Suboccipital release was given for 5 sessions (alternate days) for 10 days. Outcome Measures: Numerical pain rating scale, Neck disability Index and Cervical range of motion was used as outcome measures. Results: There was marked decrease in pain intensity from 8 on NPRS to 1 on NPRS. Also there was increase in cervical range of motion specially flexion, lateral flexion and rotation and decrease in neck disability index from 28 to 10. Conclusion: Physical therapy with TENS, Cervical spine mobilization & sub occipital release can be used as an effective intervention protocol for reducing pain and stiffness and increasing range of motion in patients with Cervicogenic Headache. Key words: Transcutaneous electrical nerve stimulation, Cervical Spine mobilization, Suboccipital release, Cervicogenic Headache, Numerical Pain Rating Scale, Neck Disability Index.

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COMPARING THE EFFICACY OF UPPER TRAPEZIUS KINESIOTAPING AND STRETCHING EXERCISES IN PATIENTS WITH MECHANICAL NECK ACHE

Pakistan Journal of Rehabilitation ◽

10.36283/pjr.zu.8.1/005 ◽

2019 ◽

Vol 8 (1) ◽

pp. 19-24

Author(s):

Qurat Ul Ain Ausaf

Keyword(s):

Physical Therapy ◽

Muscle Strength ◽

Neck Pain ◽

Pain Intensity ◽

Functional Disability ◽

Neck Disability Index ◽

Trapezius Muscle ◽

Upper Trapezius ◽

Upper Trapezius Muscle ◽

Neck Disability

BACKGROUND AND AIM Globally, around one third of population is suffering from persistent neck pain and it is considered as 4th important source of disability in the population. Several treatment protocols are available now a day to facilitate patient recovery. Therefore, the aim of this study is to identify the effects of kinesiotaping in improving neck pain, upper trapezius muscle strength and functional disability. STUDY DESIGN Randomized controlled trial SAMPLE SIZE 68 participants were recruited for the study. METHODOLOGY All participants of age 18-40 years were assessed using assessment Performa. Pain intensity, upper trapezius muscle strength and Neck disability index were measured at baseline and after treatment sessions. Group A comprised of 34 participant, received Kinesiotaping and conventional physical therapy treatment whereas, equal number of participants were recruited in Group B that received upper trapezius stretching and conventional physical therapy. RESULT The study revealed that both interventions (Kinesiotaping and stretching) were effective i.e., <0.05 in improving pain intensity, muscle strength and functional disability in patients with mechanical neck ache but significant improvement were recorded in group treated with kinesiotaping. CONCLUSION The study concluded that both interventions are effective in improving pain intensity, muscle strength and neck disability index but kinesiotaping is more beneficial than stretching among patient with mechanical neck ache.

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Features of conducting medial branches radiofrequency neurotomy in the cervical spine

Endovascular Neuroradiology ◽

10.26683/2304-9359-2018-2(24)-37-43 ◽

2018 ◽

Vol 24 (2) ◽

pp. 37-43

Author(s):

V.G. Sichinava

Keyword(s):

Cervical Spine ◽

Pain Intensity ◽

Functional State ◽

Neck Disability Index ◽

Chronic Neck Pain ◽

Spinal Nerve ◽

Medial Branch ◽

Preoperative Pain ◽

Factors Affecting ◽

Radiofrequency Neurotomy

Objective — optimize the technique of radiofrequency destruction of the medial branch of the spinal nerve and evaluate its effectiveness in the treatment of reflex pain syndromes of the cervical spine. Materials and methods. In 30 patients with chronic pain in the neck and upper extremities who were treated in the department of neurosurgery N 2 of the Kyiv City Clinical Emergency Hospital from 2014 to 2017, the effectiveness of the radiofrequency neurotomy of the medial branch of the spinal cord back root and the clinical significance of diagnostic blockades. There were 14 men (46.7 %), women — 16 (53.3 %). The age of the patients is from 38 to 75 years (the average age is 53.7 years). Neurotomy was performed in patients with chronic neck pain with irradiation in the upper limbs, in which diagnostic blockades were effective. The study did not include patients with myelopathy and radiculopathy. Preoperative pain intensity ranges from 5 to 9 points (on average, 7.50 ± 0.86 points) on a visual analog scale (VAS). The duration of pain before surgery ranged from 6 months to 20 years (an average is 3.5 years). In 21 patients, the pain was one-sided (9 in the right, 12 in the left), and the others with a bilateral one. All patients underwent clinical and neurological examination, roentgenography of the cervical spine and magnetic resonance imaging. The efficacy of the therapy was assessed with the help of the VAS, the functional state using the NDI (Neck Disability Index) questionnaire. Results. The pain intensity was assessed after 1, 3, 6 and 12 months. The pain intensity according to the VAS decreased from (7.50 ± 0.86) point before the operation to (2.07 ± 0.74) points after 12 months. A significant statistically significant (p < 0.05) improvement in the functional state compared with the baseline was noted in the postoperative period. Preoperative functional status was assessed on average (27.80 ± 1.19) points on the NDI scale. A week after the neurotomy, there was a statistically significant decrease in the total score on the NDI scale to an average of 12.90 ± 0.69, after 12 months to 13.10 ± 1.01. Conclusions. Factors affecting the effectiveness of radiofrequency destruction include the proper selection of patients, the accuracy of diagnostic tests and the technically correct installation of the electrode. Knowledge of the anatomical features of the medial branch of the spinal nerve, the X-ray anatomy, the characteristics and size of the damage during radiofrequency destruction ensure the effectiveness of neurotomy.

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