Examining the Range of Motion of the Cervical Spine: Utilising Different Bedside Instruments

Background: This paper outlines a summary of examination technique to identify the range of movement of the cervical spine. Due to common difficulties in obtaining tools for cervical examination within the district, a standardised compilation of easy-to-replicate examination techniques are provided using different tools. Methods: Bedside instruments that can be used includes a measuring tape, compass, goniometer, inclinometer and cervical range of motion (CROM) instrument. Discussion: Cervical flexion-extension, lateral flexion and rotation will be assessed with bedside instruments. This would aid in increasing accuracy and precision of objective measurement while conducting clinical examination to determine the cervical range of motion.

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Comparison of the efficacy of three cervical collars in restricting cervical range of motion: A randomized study

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907918809499 ◽

2018 ◽

Vol 27 (1) ◽

pp. 24-29 ◽

Cited By ~ 2

Author(s):

Jae Guk Kim ◽

Sung Hwan Bang ◽

Gu Hyun Kang ◽

Yong Soo Jang ◽

Wonhee Kim ◽

...

Keyword(s):

Cervical Spine ◽

Range Of Motion ◽

Cervical Spine Injury ◽

Axial Rotation ◽

The Other ◽

Spine Injury ◽

Cervical Range Of Motion ◽

Flexion Extension ◽

Cervical Immobilization ◽

The Difference

Background: The cervical collar has been used as a common device for the initial stabilization of the cervical spine. Although many cervical collars are commercially available, there is no consensus on which offers the greatest protection, with studies showing considerable variations in their ability to restrict cervical range of motion. The use of the XCollar (Emegear, Carpinteria, CA) has been known to decrease the risk of spinal cord injury by minimizing potential cervical spinal distraction. We compared XCollar with two other cervical collars commonly used for adult patients with cervical spine injury to evaluate the difference in effectiveness between the three cervical collars to restrict cervical range of motion. Objectives: This study aimed to evaluate the difference between the three cervical collars in their ability to restrict cervical range of motion. Method: A total of 30 healthy university students aged 21–25 years participated in this study. Participants with any cervical disease and symptoms were excluded. Three cervical collars were tested: Philadelphia® Collar, Stifneck® Select™ Collar, and XCollar. A digital camera and an image-analysis technique were used to evaluate cervical range of motion during flexion, extension, bilateral bending and bilateral axial rotation. Cervical range of motion was evaluated in both the unbraced and braced condition. Results: XCollar permitted less than a mean of 10° of movement during flexion, extension, bilateral bending and bilateral axial rotation. This was less than the movement permitted by the other two cervical collars. Conclusion: XCollar presented superior cervical immobilization compared to the other two commonly used cervical collars in this study. Thus, when cervical collar is considered for an adult patient with cervical spine injury, XCollar might be one of the considerate options as a cervical immobilization device.

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Range of Motion of the Upper Cervical Spine: flexion, extension, lateral bending, and axial rotation

Jornada de Jóvenes Investigadores del I3A ◽

10.26754/jjii3a.4877 ◽

2020 ◽

Vol 8 ◽

Author(s):

Ana I. Lorente ◽

César Hidalgo García ◽

Jacobo Rodríguez Sanz ◽

Mario Maza Frechín ◽

Albert Pérez Bellmunt

Keyword(s):

Cervical Spine ◽

Range Of Motion ◽

Axial Rotation ◽

Upper Cervical Spine ◽

Lateral Bending ◽

Normal Range ◽

Range Of Movement ◽

Flexion Extension ◽

Upper Cervical ◽

Life Threatening

Instability is a serious and life-threatening diagnosis in the upper cervical spine (occiput-atlas-axis), and a depth understanding of normal range of movement is required for clinical manual evaluation. To improve this knowledge, ten upper cervical spine specimens have been tested in flexion, extension, lateral bending, and axial rotation.

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EFEITOS DO DEEP RUNNING SOBRE A AMPLITUDE DE MOVIMENTO E A CAPACIDADE FUNCIONAL DOS MEMBROS SUPERIORES DE MULHERES MASTECTOMIZADAS: RELATO DE CASOS

Revista Científica JOPEF ◽

10.34059/ciejop.2019v27i1-11 ◽

2019 ◽

pp. 121-131

Keyword(s):

Range Of Motion ◽

Upper Limb ◽

Functional Capacity ◽

External Rotation ◽

Treatment Protocol ◽

Range Of Movement ◽

Flexion Extension ◽

Before And After ◽

In The Beginning ◽

And Function

Introduction: Breast cancer is the most common type of cancer among women in Brazil and in the worl. The surgical treatment procedure may cause severe morbidity in the upper limb homolateral to surgery, including the reduction of the range of motion, with consequent impairment of function. A physiotherapeutic approach has an important role in the recover range of motion and the functionality of these women, guaranteeing the occupational, domestestic, familiar and conjugated activities, and, in this way, also improving the quality of life. Objectives: To analyse chances in the shoulder's range of motion and the functional capacity of the upper limbs, promoted by the deep running procedure in women with late postoperative mastectomy. Methods: All the patients were submitted to an evaluation in the beginning and end of the treatment, including: goniometry of flexion, extension, abduction, adduction, internal and external rotation of the shoulder joint; and function capacity analysis in activities that involve the upper members by DASH questionnaire. The treatment protocol includes twelve sessions of deep running, realized twice a week, in deep pool, for 20-minute during six weeks. Results: Were submitted to treatment a total of 4 patients. Despite the improvement in the numerical values, statistically significant differences were not found on the range of movements and in the functional capacity of upper members before and after the deep running sessions in post-mastectomy women. Conclusion: Deep running had effects on the numerical values of range of movement and upper limb functionality in women in the late postoperative period of the mastectomy procedure, but without statistically significant differences.

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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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Neck Active Movements Assessment in Women with Episodic and Chronic Migraine

Journal of Clinical Medicine ◽

10.3390/jcm10173805 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3805

Author(s):

Carina F. Pinheiro ◽

Anamaria S. Oliveira ◽

Tenysson Will-Lemos ◽

Lidiane L. Florencio ◽

César Fernández-de-las-Peñas ◽

...

Keyword(s):

Cervical Spine ◽

Angular Velocity ◽

Range Of Motion ◽

Chronic Migraine ◽

Muscle Activity ◽

Cervical Range Of Motion ◽

Movement Parameters ◽

Neck Disability ◽

Asymptomatic Control ◽

Muscular Activation

We aimed to compare movement parameters and muscle activity during active cervical spine movements between women with episodic or chronic migraine and asymptomatic control. We also assessed the correlations between cervical movement measures with neck-related disability and kinesiophobia. Women with episodic (n = 27; EM) or chronic (n = 27; CM) migraine and headache-free controls (n = 27; CG) performed active cervical movements. Cervical range of motion, angular velocity, and percentage of muscular activation were calculated in a blinded fashion. Compared to CG, the EM and CM groups presented a reduced total range of motion (p < 0.05). Reduced mean angular velocity of cervical movement was also observed in both EM and CM compared to CG (p < 0.05). Total cervical range of motion and mean angular velocity showed weak correlations with disability (r = −0.25 and −0.30, respectively; p < 0.05) and weak-to-moderate correlations with kinesiophobia (r = −0.30 and −0.40, respectively; p < 0.05). No significant correlation was observed between headache features and total cervical range of motion or mean angular velocity (p > 0.05). No differences in the percentage of activation of both flexors and extensors cervical muscles during active neck movements were seen (p > 0.05). In conclusion, episodic and chronic migraines were associated with less mobility and less velocity of neck movements, without differences within muscle activity. Neck disability and kinesiophobia are negative and weakly associated with cervical movement.

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Cervical Spine Joint Hypermobility: A Possible Predisposing Factor for New Daily Persistent Headache

Cephalalgia ◽

10.1111/j.1468-2982.2006.01187.x ◽

2006 ◽

Vol 26 (10) ◽

pp. 1182-1185 ◽

Cited By ~ 40

Author(s):

TD Rozen ◽

JM Roth ◽

N Denenberg

Keyword(s):

Cervical Spine ◽

Range Of Motion ◽

Physical Therapists ◽

Joint Hypermobility ◽

New Daily Persistent Headache ◽

Beighton Score ◽

Predisposing Factor ◽

Cervical Range Of Motion ◽

Persistent Headache

The objective of this study was to suggest that joint hypermobility (specifically of the cervical spine) is a predisposing factor for the development of new daily persistent headache (NDPH). Twelve individuals (10 female, 2 male) with primary NDPH were evaluated by one of two physical therapists. Each patient was tested for active cervical range of motion and for the presence of excessive intersegmental vertebral motion in the cervical spine. All patients were screened utilizing the Beighton score, which determines degree of systemic hypermobility. Eleven of the 12 NDPH patients were found to have cervical spine joint hypermobility. Ten of the 12 NDPH patients had evidence of widespread joint hypermobility with the Beighton score. Based on our findings we suggest that joint hypermobility, specifically of the cervical spine, may be a predisposing factor for the development of NDPH.

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A Novel Application of Head Tracking Data in the Analysis and Assessment of Operational Cervical Spine Range of Motion for Army Aviators

Military Medicine ◽

10.1093/milmed/usaa270 ◽

2021 ◽

Vol 186 (Supplement_1) ◽

pp. 645-650

Author(s):

Steven T Williams ◽

Adrienne M Madison ◽

Frederick T Brozoski ◽

Valeta Carol Chancey

Keyword(s):

Cervical Spine ◽

Range Of Motion ◽

Three Dimensional ◽

Head Position ◽

Head Tracking ◽

Tracking Data ◽

Project Management Office ◽

Flexion Extension ◽

Position Data ◽

Rotary Wing

ABSTRACT Introduction Neck pain among rotary-wing aviators has been established as an important issue in the military community, yet no U.S. Army regulation defines exactly what cervical spine range of motion (CROM) is adequate for flight. This lack of regulation leaves flight surgeons to subjectively determine whether an aviator affected by limited CROM is fit to maintain flight status. The U.S. Army Aeromedical Research Laboratory is conducting a study among AH-64 and UH-60 pilots to define CROM requirements in simulated and actual flight using optical head tracking equipment. Presented here is a preliminary analysis of head position data from a pilot and co-pilot in two AH-64 missions. Methods Maintenance data recorder (MDR) files from two AH-64 missions were provided by the Apache Attack Helicopter Project Management Office. Data were filtered down to three-dimensional pilot and co-pilot head position data and each data point was analyzed to determine neck posture. These neck postures were then categorized as neutral, mild, and severe for flexion/extension, lateral bending, and twist rotation postural categories. Results Twist rotation postures reached 90 degrees, particularly early in the flight; additionally, a few instances of 90-degree lateral bends were observed. Co-pilots spent more time than pilots in mild and severe twist rotation posture for both flights. Co-pilots also spend a high percentage of time in mild flexion and twist rotation. Conclusion This investigation provides a proof of concept for analysis of head tracking data from MDR files as a surrogate measure of neck posture in order to estimate CROM requirements in rotary-wing military flight missions. Future studies will analyze differences in day and night flights, pilot versus co-pilot CROM, and neck movement frequency.

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Cervical End-Range Joint Motion Does Not Indicate Maximum Cervical Joint Motion In Healthy Adults. An Observational Study

10.21203/rs.3.rs-90272/v1 ◽

2020 ◽

Author(s):

Victoria Blogg Andersen ◽

Xu Wang ◽

Mark De Zee ◽

Lasse Riis Østergaard ◽

Maciej Plocharski ◽

...

Keyword(s):

Observational Study ◽

Range Of Motion ◽

Healthy Subjects ◽

Joint Motion ◽

Cervical Range Of Motion ◽

Range Type ◽

Flexion Extension ◽

The Difference ◽

Video Fluoroscopy ◽

Average Contribution

Abstract BackgroundIn clinical diagnosis, the largest motion associated with cervical range of motion is thought to be found at end-range and it is this perception that forms the basis for the interpretation of flexion/extension studies. There have however, been representative cases of joints producing their maximum motion before end-range, but this phenomenon is yet to be quantified. PurposeTo provide a quantitative assessment of the difference between maximum motion and end-range in healthy subjects. Secondarily to classify joints into type based on their motion and to assess the proportions of these joint types. Study designThis is an observational study. Subject sampleThirty three healthy subjects participated in the study. Outcome measuresMaximum motion, end-range motion and surplus motion in degrees were extracted from each cervical joint. MethodsThirty-three subjects performed one flexion and one extension motion excursion under video fluoroscopy. The motion excursions were divided into 10 percent epochs between the initial upright position and the end-range position, from which maximum motion, end-range and surplus motion were extracted. Surplus motion was then assessed in quartiles and joints were classified into type according to end-range. ResultsFor flexion 48.9% and for extension 47.2% of joints produced maximum motion before end-range (type Surplus). For flexion 45.9% and for extension 46.8% of joints produced maximum motion at end-range (type Classic) and 5.2% of joints in flexion and 6.1% of joints in extension concluded their motion anti-directionally (type Anti-directional). Mann-Whitney U tests produced significant results for C2/C3, C3/C4 and C4/C5 in flexion and C1/C2, C3/C4 and C6/C7 in extension when comparing end- range motion for type Classic and type Surplus. The average contributions to cervical range-of-motion (ROM) (C0 to C7) for flexion and extension were 60.23֯ and 67.86֯ for type Classic and 42.22֯ and 49.05֯ for type Surplus respectively. Thus, the average contribution to cervical ROM was larger for type Classic than for type Surplus. The average pro-directional surplus motion was 2.41֯ ± 2.12֯ with a range of range (0.07֯ -14.23֯) for flexion and 2.02֯ ± 1.70֯ with a range of 0.04°-6.97° for extension.ConclusionThis is the first study to categorise joints by type of motion. Type Surplus constituted approximately half of the joints analysed in this study. Therefore, end-range motion cannot be assumed to be a demonstration of a joint´s maximum motion.

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Reliability of an Integrated Inertial Sensor for the Continuous Measurement of Active Cervical Range of Motion in a Group of Younger and Elderly Individuals

Journal of Functional Morphology and Kinesiology ◽

10.3390/jfmk5030058 ◽

2020 ◽

Vol 5 (3) ◽

pp. 58

Author(s):

Stefano Gobbo ◽

Barbara Vendramin ◽

Enrico Roma ◽

Federica Duregon ◽

Danilo Sales Bocalini ◽

...

Keyword(s):

Older Adults ◽

Range Of Motion ◽

Inertial Sensor ◽

Zero Point ◽

Lateral Bending ◽

Cervical Range Of Motion ◽

Flexion Extension ◽

Test Retest Reliability ◽

Motion Assessment ◽

Good Agreement

The aim of this study was to evaluate the test–retest reliability of an integrated inertial sensor (IIS) for cervical range of motion assessment. An integrated inertial sensor was placed on the forehead center of thirty older adults (OA) and thirty younger adults (YA). Participants had to perform three continuous rotations, lateral bandings and flexion–extensions with their head. Test–retest reliability was assessed after 7 days. YA showed moderate to good agreement for rotation (0.54–0.82), lateral bending (0.74–0.8), and flexion–extension (0.74–0.81) movements and poor agreement for zero point (ZP). OA showed moderate to good agreement for rotation (0.65–0.86), good to excellent agreement in lateral bending (0.79–0.92), and poor to moderate agreement for flexion–extension (0.37–0.72). Zero point showed poor to moderate agreement. In conclusion, we can affirm that this IIS is a reliable device for cervical range of motion assessment in young and older adults; on the contrary, the ZP seems to be unreliable and the addition of an external reference point could help the subject to solve this shortcoming and reduce possible biases.

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