Validity and reliability of two Smartphone applications to measure the lower and upper cervical spine range of motion in subjects with chronic cervical pain

BACKGROUND: Damage on the somatosensory system could cause sensation of dizziness, a condition known as cervicogenic dizziness (CD). Manual physical therapy has shown beneficial effects, relieving the symptoms of cervicogenic dizziness. However, the effect of upper cervical spine manipulation is unknown, as this is a technique that respects the International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) safety criteria. OBJECTIVE: To assess the effects of upper cervical spine traction-manipulation in subjects with cervicogenic dizziness. METHODS: This was a descriptive case series study. Treatment focused on the upper cervical spine manipulation procedure. Evaluation was performed before and after the treatment. Variables recorded include upper and lower cervical range of motion, Cervical Flexion-Rotation Test (CFRT), dizziness intensity and cervical pain (VAS), self-perceived dizziness measured with Dizziness Handicap Inventory (DHI) and subjective perception of outcome (GROC-scale). RESULTS: Ten subjects were recruited. After the treatment protocol, there was an increased range of movement towards the most restricted side, as measured by the CFRT (p< 0.001), decreased intensity of dizziness (p< 0.001) and intensity of pain (p< 0.001). Functional capacity also improved after the intervention (p< 0.011). CONCLUSION: Upper cervical spine manipulation may decrease dizziness intensity and cervical pain and improve functional ability and upper cervical spine mobility in patients with cervicogenic dizziness.

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Active Range of Motion as an Indicator for Ligament and Membrane Lesions in the Upper Cervical Spine after a Whiplash Trauma

Journal of Neurotrauma ◽

10.1089/neu.2006.0193 ◽

2007 ◽

Vol 24 (4) ◽

pp. 713-721 ◽

Cited By ~ 16

Author(s):

Bertel Rune Kaale ◽

Jostein Krakenes ◽

Grethe Albrektsen ◽

Knut Wester

Keyword(s):

Cervical Spine ◽

Range Of Motion ◽

Upper Cervical Spine ◽

Active Range Of Motion ◽

Upper Cervical ◽

Whiplash Trauma

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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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To Compare the Immediate Effects of Active Cranio Cervical Flexion Exercise Versus Passive Mobilization of Upper Cervical Spine on Pain, Range of Motion and Cranio Cervical Flexion Test in Patients with Chronic Neck Pain

Indian Journal of Physiotherapy and Occupational Therapy - An International Journal ◽

10.5958/0973-5674.2018.00050.3 ◽

2018 ◽

Vol 12 (3) ◽

pp. 22 ◽

Cited By ~ 1

Author(s):

Amrit Kaur ◽

Komal Mali ◽

Mahesh Mitra

Keyword(s):

Cervical Spine ◽

Neck Pain ◽

Range Of Motion ◽

Chronic Neck Pain ◽

Upper Cervical Spine ◽

Upper Cervical ◽

Passive Mobilization ◽

Flexion Test

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The upper cervical spine tumor pathology C1-C2 - therapeutic attitude

Romanian Neurosurgery ◽

10.2478/v10282-012-0012-3 ◽

2012 ◽

Vol 19 (4) ◽

pp. 251-263 ◽

Cited By ~ 2

Author(s):

D. Serban ◽

N.A. Calina ◽

Fl. Exergian ◽

M. Podea ◽

C. Zamfir ◽

...

Keyword(s):

Cervical Spine ◽

Posterior Approach ◽

Surgical Techniques ◽

Neurological Deficits ◽

Upper Cervical Spine ◽

Cervical Pain ◽

Presenting Symptoms ◽

Spine Tumors ◽

Tumor Pathology ◽

Upper Cervical

Abstract Surgical treatment of upper cervical spine tumors, whether they are vertebral, epidural, subdural or intramedullary, raises technical and decisional difficulties regarding the approach of the region as well as in maintaining its stability. The authors performed a retrospective study on C1, C2 spinal tumor pathology, managed surgically in the Spinal Surgery Department of Bagdasar Arseni Clinical Hospital, between January 2007 and December 2011. We included in the study 44 patients, operated for C1, C2 cervical spine tumors, 23 men and 21 women with ages between 13 and 71 years. The pathology included 24 C1-C2 vertebral tumors, 11 subdural tumors, 2 epidural tumors and 7 intramedullary tumors. Presenting symptoms were cervical pain, occipital neuralgia, medullary compression syndrome, and/or cranio-spinal junction instability. The purpose of surgery was to establish a histopathologic diagnosis and to decompress the neural elements by attempting a total tumor removal as well as to stabilize the cranio - cervical junction in order to improve the patient's quality of life. The approach was chosen based on tumor location, prognosis and the need for fixation. For 6 patients an anterior approach was used, for 31 pacients we used a posterior approach and 7 patients required a combined anterior and posterior approach. Neurological improvement was observed in 17 patients, with a mean increase of 8 points on ASIA scale, 7 patients worsened immediately postoperatively with a mean decrease of 10 points on ASIA scale, (2 patients died), and 20 patients without neurological deficits preoperatively remained unchanged. In all cases where the craniospinal junction instability was the cause of occipito-cervical pain we noted the disappearence of pain after surgery. The development of new surgical techniques and fixation systems paved the way to a successful treatment for these difficult tumors, some of them considered inoperable in the past.

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

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03525-6 ◽

2020 ◽

Vol 21 (1) ◽

Cited By ~ 3

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.

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Effect of Active Cranio Cervical Flexion Exercise of Upper Cervical Spine on Pain, Cervical Range of Motion and Craniocervical Flexion Test (CCFT) in Patients with Age Group 20–40 Years of Chronic Neck Pain

Indian Journal of Physiotherapy and Occupational Therapy - An International Journal ◽

10.5958/0973-5674.2019.00047.9 ◽

2019 ◽

Vol 13 (2) ◽

pp. 64

Author(s):

Ganesh MSP ◽

Komal Mali

Keyword(s):

Cervical Spine ◽

Neck Pain ◽

Range Of Motion ◽

Chronic Neck Pain ◽

Upper Cervical Spine ◽

Age Group ◽

Cervical Range Of Motion ◽

Upper Cervical ◽

Flexion Test

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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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