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Russell BS, Keller M, Wynd SE, Hosek RS, Owens EF, Hoiriis KT. Angular Kinematics of Chiropractic Supine Cervical Spine Manipulation: Rotational Measures and Comparisons to Doctor and Recipient Perceptions. J Manipulative Physiol Ther 2022; 45:497-507. [PMID: 36922054 DOI: 10.1016/j.jmpt.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 10/20/2022] [Accepted: 12/01/2022] [Indexed: 03/17/2023]
Abstract
OBJECTIVES The primary purposes of this study were to measure axial rotation during supine cervical spinal manipulative therapy (cSMT) and to record recipients' and doctors' perceptions of rotational magnitudes. METHODS Experienced doctors of chiropractic (DCs) provided supine cSMT and acted as recipients of cSMT. Participants who received SMT wore inertial measurement units attached to the forehead and sternum for motion capture. Afterward, recipients and DCs completed questionnaires asking about their perceptions of motion. Data were analyzed for magnitudes of axial rotation at peak thrust and correlations with patient and doctor perceptions. Secondary analyses included angular velocity, angular acceleration, and other kinematic variables. RESULTS We recorded 23 SMT events with 14 DCs. Rotation at thrust peaks averaged 32.4° (17.4°). Doctors' and recipients' perceptions of rotation were higher than measured values 45% and 50% of the time, respectively. Maximum angular velocity and acceleration averaged 221.9°/s (124.9) and 4786.5°/s2 (2456.6), respectively. We found no correlation between perceptions and velocity or acceleration; doctors' perceptions had an inverse correlation with measurements. CONCLUSION On average, we found rotation during supine cSMT to be 32°. Both DCs and SMT recipients overestimated rotation compared with actual measurements. These factors should be considered in discussions of rotation and SMT.
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Affiliation(s)
- Brent S Russell
- Life University Center for Chiropractic Research, Atlanta, Georgia.
| | - Mackenzie Keller
- Life University Center for Chiropractic Research, Atlanta, Georgia
| | - Shari E Wynd
- Department of Foundational Sciences, Texas Chiropractic College, Pasadena, Texas
| | - Ronald S Hosek
- Life University Center for Chiropractic Research, Atlanta, Georgia
| | - Edward F Owens
- Life University Center for Chiropractic Research, Atlanta, Georgia
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Analysis of three-dimensional facet joint displacement during two passive upper cervical mobilizations. Musculoskelet Sci Pract 2020; 50:102218. [PMID: 32882623 DOI: 10.1016/j.msksp.2020.102218] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Understanding the 3D-kinematics of the upper cervical spine during manual mobilization is essential for clinical examination and therapy. Some information about rotational motion is available in literature but translational components are often ignored, complicating the understanding of the complex inter-segmental motions. OBJECTIVES This study aims to describe the amount, trajectories and reproducibility of atlanto-occipital facet joints' displacement during a flexion-extension mobilization and of the atlanto-axial facet joints during an axial rotation mobilization. DESIGN Original research using quantitative data. METHODS 20 fresh frozen human cervical specimens were examined with a Zebris® CMS20 ultrasound-based motion tracking system. Two physiotherapists performed regionalmobilizations in flexion-extension and axial rotation. The amount of displacement and the trajectories were calculated along the XYZ axes. Difference between measurements was evaluated with the Friedman two-way ANOVA test. Intra- and inter-rater reliability were estimated through ICC scores. RESULTS 3D-displacement (2.6-23.4 mm) was larger at C1-C2 during axial rotation, Atlanto-occipital flexion displayed the greatest variability in the C0 trajectory. During a right rotation, the left C1 facet moved mainly forward, and the right C1 facet moved backward. During a left rotation, the left C1 facet moved backward, while the right C1 facet moved forward. Intra-tester and Inter-tester ICCs varied between 0.5 and 0.90 (p < 0.005). CONCLUSIONS During passive spinal motion, there is an important variability in magnitude and trajectory of joints' displacement. Nevertheless, different clinicians may be able to achieve the same position at the end of the mobilization.
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Luedtke K, Schoettker-Königer T, Hall T, Enns C, Grassold M, Hasselhoff-Styhler P, Neulinger C, Obrocki M, Przyhoda P, Schäfer A. Concurrent validity and reliability of measuring range of motion during the cervical flexion rotation test with a novel digital goniometer. BMC Musculoskelet Disord 2020; 21:535. [PMID: 32781990 PMCID: PMC7422569 DOI: 10.1186/s12891-020-03525-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 07/20/2020] [Indexed: 01/09/2023] Open
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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Affiliation(s)
- Kerstin Luedtke
- Laboratory of Pain Research, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
- Institute of Health Sciences, Academic Physiotherapy, University of Luebeck, Lübeck, Germany
| | - Thomas Schoettker-Königer
- Faculty of Social Work and Health, University of Applied Science and Art (HAWK), Goschentor 1, 31134 Hildesheim, Germany
| | - Toby Hall
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA Australia
| | - Christine Enns
- Faculty of Social Sciences, University of Applied Sciences Bremen, Neustadtswall 30, 28199 Bremen, Germany
| | - Maike Grassold
- Faculty of Social Sciences, University of Applied Sciences Bremen, Neustadtswall 30, 28199 Bremen, Germany
| | - Petra Hasselhoff-Styhler
- Faculty of Social Work and Health, University of Applied Science and Art (HAWK), Goschentor 1, 31134 Hildesheim, Germany
| | - Christian Neulinger
- Faculty of Social Work and Health, University of Applied Science and Art (HAWK), Goschentor 1, 31134 Hildesheim, Germany
| | - Max Obrocki
- Faculty of Social Sciences, University of Applied Sciences Bremen, Neustadtswall 30, 28199 Bremen, Germany
| | - Philipp Przyhoda
- Faculty of Social Work and Health, University of Applied Science and Art (HAWK), Goschentor 1, 31134 Hildesheim, Germany
| | - Axel Schäfer
- Faculty of Social Work and Health, University of Applied Science and Art (HAWK), Goschentor 1, 31134 Hildesheim, Germany
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Two novel parameters to evaluate the influence of the age and gender on the anatomic relationship of the atlas and axis in children no more than 8 years old: imaging study. Neuroradiology 2019; 61:1407-1414. [DOI: 10.1007/s00234-019-02284-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 08/25/2019] [Indexed: 10/26/2022]
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Krott NL, Bloyinski GM, Cattrysse E. 3-Dimensional Cervical Movement Characteristics and the Influence of Thoracic Treatment on a Subgroup of Acute Neck Pain Patients. J Manipulative Physiol Ther 2018; 41:304-314. [PMID: 29669689 DOI: 10.1016/j.jmpt.2017.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 11/03/2017] [Accepted: 11/22/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the influence of thoracic high-velocity low-amplitude thrust (HVLAT) manipulation on quantitative and qualitative 3-dimensional cervical spine kinematic patterns in a subgroup of patients with acute neck pain. METHODS Thirty patients with acute neck pain, aged 20 to 59, received a thoracic HVLAT manipulation. Three-dimensional kinematics of the cervical spine were registered pretreatment and posttreatment using an electromagnetic tracking system. Quantitative and qualitative parameters were calculated for axial rotation, lateral bending, and flexion-extension movement. Subjective pain ratings were measured with the visual analogue scale and the Neck Disability Index and were collected pretreatment and posttreatment. RESULTS After treatment, the range of motion of the main motion improved significantly for axial rotation (P = .034), lateral bending (P < .001), and flexion-extension (P = .031). Although for axial rotation as the main motion, the smoothness of the flexion-extension movement improved significantly after treatment (P = .036), the reverse was true for flexion-extension as the main motion. Visual analogue scale scores exhibited a statistically (P < .001) and clinically significant reduction of pain sensation. The mean change in Neck Disability Index scores only exhibited a statistically significant improvement 1 week after treatment. CONCLUSION Thoracic HVLAT manipulation led to positive changes in quantitative and qualitative aspects of 3-dimensional cervical spine kinematics. Because of the 1-intervention group design, external factors influencing the healing process could not be eliminated.
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Affiliation(s)
- Nikolas L Krott
- Department of Experimental Anatomy and Arthrokinematics Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Gunnar M Bloyinski
- Department of Experimental Anatomy and Arthrokinematics Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Erik Cattrysse
- Department of Experimental Anatomy and Arthrokinematics Research Group, Vrije Universiteit Brussel, Brussels, Belgium
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Buzzatti L, Provyn S, Van Roy P, Cattrysse E. Atlanto-axial facet displacement during rotational high-velocity low-amplitude thrust: An in vitro 3D kinematic analysis. ACTA ACUST UNITED AC 2015; 20:783-9. [DOI: 10.1016/j.math.2015.03.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 03/03/2015] [Accepted: 03/11/2015] [Indexed: 11/29/2022]
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Beyer B, Sobczak S, Salem W, Feipel V, Dugailly PM. 3D motion reliability of occipital condylar glide testing: From concept to kinematics evidence. ACTA ACUST UNITED AC 2015; 21:159-64. [PMID: 26261003 DOI: 10.1016/j.math.2015.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 07/03/2015] [Accepted: 07/09/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND To date, segmental data analyzing kinematics of occipital condylar testing or mobilization is lacking. OBJECTIVES The objective of this study was to assess occipitoatlantal 3D motion components and to analyze inter- and intra-rater reliability during in vitro condylar glide test. METHODS To conduct this study, four fresh cadavers were included. Dissection was carried out to ensure technical clusters placement to skull, C1 and C2. During condylar glide test, bone motion data was computed using an optoelectronic system. The reliability of motion kinematics was assessed for three skilled practitioners performing two sessions of 3 trials on two days interval. FINDINGS During testing, average absolute motion ROM (±SD) were up to 4.1 ± 2.1°, 0.7 ± 1.3° and 10.3 ± 2.5° for occipitoatlantal lateral bending, axial rotation and flexion-extension, respectively. For position variation, magnitudes were 2.3 ± 1.8 mm, 1.1 ± 1.3 mm and 2.6 ± 0.8 mm for anteroposterior, cephalocaudal and mediolateral displacements. Concerning motion reliability, variation ranged from 0.6° to 3.4° and from 0.3 mm to 1.6 mm for angular displacement and condyle position variation, respectively. In general, good to excellent agreement was observed (ICC ranging from 0.728 to 0.978) for the same operator, while consistency was limited to lateral/side bending and lateral condyle displacement between operators, with respective ICCs of 0.800 and 0.955. CONCLUSIONS This study shows specific motion patterns involving extension and lateral bending of the occipitoatlantal level for anterior condylar glide test. In addition, condyle position variation demonstrated coupled components in forward and heterolateral directions. However, task seems not to be side specific. In general, reliability of 3D motion components showed good intra-operator agreement and limited inter-operator agreement.
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Affiliation(s)
- Benoît Beyer
- Research Unit in Osteopathy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Functional Anatomy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Stéphane Sobczak
- Research Unit in Osteopathy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Functional Anatomy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Walid Salem
- Research Unit in Osteopathy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Véronique Feipel
- Laboratory of Functional Anatomy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Pierre-Michel Dugailly
- Research Unit in Osteopathy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Functional Anatomy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium.
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Dugailly PM, Sobczak S, Van Geyt B, Bonnechère B, Maroye L, Moiseev F, Rooze M, Salvia P, Feipel V. Head-trunk kinematics during high-velocity-low-amplitude manipulation of the cervical spine in asymptomatic subjects: helical axis computation and anatomic motion modeling. J Manipulative Physiol Ther 2015. [PMID: 26215899 DOI: 10.1016/j.jmpt.2014.10.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to analyze the in vivo 3-dimensional kinematics of the head during cervical manipulation including helical axis (HA) computation and anatomic motion representation. METHODS Twelve asymptomatic volunteers were included in this study. An osteopathic practitioner performed 1 to 3 manipulations (high-velocity and low-amplitude [HVLA] multiple component technique) of the cervical spine (between C2 and C5) with the patient in the sitting position. During manipulation, head motion was collected using an optoelectronic system and expressed relative to the thorax. Motion data were processed to analyze primary and coupled motions and HA parameters. Anatomic motion representation including HA was obtained. RESULTS During manipulation, average maximal range of motion was 39° (SD, 6°), 21° (SD, 7°), and 8° (SD, 5°) for lateral bending (LB), axial rotation (AR), and flexion extension, respectively. For the impulse period, magnitude averaged of 8° (SD, 2°), 5° (SD, 2°), and 3° (SD, 2°), for LB, AR, and flexion extension, respectively. Mean impulse velocity was 139°/s (SD, 39°/s). Concerning AR/LB ratios, an average of 0.6 (SD, 0.3) was observed for global motion, premanipulation positioning, and impulse. Mean HA was mostly located ipsilateral to the impulse side and displayed an oblique orientation. CONCLUSION This study demonstrated limited range of AR during cervical spine manipulation and provided new perspectives for the development of visualization tools, which might be helpful for practitioners and for the analysis of cervical manipulation using HA computation and anatomic representation of motion.
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Affiliation(s)
- Pierre-Michel Dugailly
- Professor, Department of Osteopathic Sciences, Université Libre de Bruxelles, Bruxelles, Belgium.
| | - Stéphane Sobczak
- Scientific Collaborator, Laboratory of Biomechanics, Anatomy and Organogenesis, Faculty of Medicine, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Bernard Van Geyt
- Scientific Collaborator, Laboratory of Functional Anatomy, Faculty of Motor Sciences, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Bruno Bonnechère
- Assistant Teacher, Laboratory of Biomechanics, Anatomy and Organogenesis, Faculty of Medicine, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Laura Maroye
- Assistant Teacher, Research Unit in Osteopathy, Faculty of Motor Sciences, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Fedor Moiseev
- Scientific Collaborator, Laboratory of Biomechanics, Anatomy and Organogenesis, Faculty of Medicine, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Marcel Rooze
- Professor and Head of the Department of Anatomy Laboratory of Biomechanics, Anatomy and Organogenesis, Faculty of Medicine, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Patrick Salvia
- Scientific Collaborator, Laboratory of Biomechanics, Anatomy and Organogenesis, Faculty of Medicine, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Véronique Feipel
- Professor, Laboratory of Functional Anatomy, Faculty of Motor Sciences, Université Libre de Bruxelles, Bruxelles, Belgium
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Cattrysse E, Gianola S, Provyn S, Van Roy P. Intended and non-intended kinematic effects of atlanto-axial rotational high-velocity, low-amplitude techniques. Clin Biomech (Bristol, Avon) 2015; 30:149-52. [PMID: 25556040 DOI: 10.1016/j.clinbiomech.2014.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 12/12/2014] [Accepted: 12/15/2014] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The study of neck kinematics during high-velocity, low-amplitude manipulations of the atlanto-axial segment is essential to understanding cervical motion mechanisms and their impact and possible risk for soft-tissue injuries during treatment of spine disorders. METHODS Twenty fresh-frozen specimens were tested during manual application of an axial rotation technique. FINDINGS The kinematics indicate the thrust induced motion components of approximately 1° at the treated segment around all three axes of the local embedded reference frame. Moreover, an equal amount of axial rotation motion took place at the adjacent atlanto-occipital joint. INTERPRETATION Overall atlanto-axial motion remained below the level of slow regional mobilization of the cervical spine. These findings can be correlated to literature data concerning the limited increase in vertebral artery strain during high-velocity, low-amplitude manipulation.
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Affiliation(s)
- Erik Cattrysse
- Vrije Universiteit Brussel, Department of Experimental Anatomy, Laarbeeklaan 103, 1090 Brussels, Belgium.
| | - Silvia Gianola
- Vrije Universiteit Brussel, Department of Experimental Anatomy, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Steven Provyn
- Vrije Universiteit Brussel, Department of Experimental Anatomy, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Peter Van Roy
- Vrije Universiteit Brussel, Department of Experimental Anatomy, Laarbeeklaan 103, 1090 Brussels, Belgium
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Reproducibility of the Kinematics in Rotational High-Velocity, Low-Amplitude Thrust of the Upper Cervical Spine: A Cadaveric Study. J Manipulative Physiol Ther 2015; 38:51-58. [DOI: 10.1016/j.jmpt.2014.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 02/18/2014] [Accepted: 03/28/2014] [Indexed: 11/20/2022]
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Dugailly PM, Beyer B, Sobczak S, Salvia P, Rooze M, Feipel V. Kinematics of the upper cervical spine during high velocity-low amplitude manipulation. Analysis of intra- and inter-operator reliability for pre-manipulation positioning and impulse displacements. J Electromyogr Kinesiol 2014; 24:621-7. [DOI: 10.1016/j.jelekin.2014.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 05/07/2014] [Accepted: 05/07/2014] [Indexed: 11/29/2022] Open
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Global and regional kinematics of the cervical spine during upper cervical spine manipulation: A reliability analysis of 3D motion data. ACTA ACUST UNITED AC 2014; 19:472-7. [DOI: 10.1016/j.math.2014.04.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 04/22/2014] [Accepted: 04/28/2014] [Indexed: 11/22/2022]
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Abstract
STUDY DESIGN Cohort study. OBJECTIVE To generate normal values for active range of motion (ACROM) of the cervical spine in asymptomatic persons. SUMMARY OF BACKGROUND DATA There is a lack of normal values for ACROM based on large groups and stratified for different age categories. METHODS Four hundred asymptomatic persons were included, 100 for each decade of age from 20 years to 60 years and in each subgroup 50 males and 50 females. ACROM was measured with the cervical range of motion (CROM) device. Analysis of variance and the Scheffé post hoc test was used to investigate the differences of ACROM between the decades of age. Linear regression analysis was performed to examine the influence of age and sex on ACROM. RESULTS The results of this study show that the ACROM decreases significantly in persons older than 50 years for all directions except extension and side flexion compared with that in the subgroup aged 40 to 50. Age had an overall significant effect on the ACROM for all directions. Sex proved to have no significant effect on the ACROM. CONCLUSION Normal values were established for ACROM in a group of 400 persons without neck complaints. It was demonstrated that age has a significant influence on the ACROM, but sex has no influence. LEVEL OF EVIDENCE N/A.
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Cattrysse E, Provyn S, Kool P, Clarys JP, Van Roy P. Morphology and kinematics of the atlanto-axial joints and their interaction during manual cervical rotation mobilization. ACTA ACUST UNITED AC 2011; 16:481-6. [PMID: 21511513 DOI: 10.1016/j.math.2011.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 03/08/2011] [Accepted: 03/14/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND DATA At present little data are available on the relationship between spinal anatomy and kinematics. No studies have verified the relationship between atlanto-axial kinematics during manual mobilization and the spatial features of the atlanto-axial ligaments and the lateral joints. MATERIALS AND METHODS Twenty un-embalmed cervical spine specimens (9 male and 11 female; 80 ± 11 years) were studied. Atlanto-axial kinematics were registered during manual axial rotation mobilization using an ultrasound-based motion tracking system. Anatomical landmarks were digitized and spatial features of the lateral atlanto-axial joint surfaces and alar ligaments were extracted. The relationship between the anatomical features and the spinal kinematics was analyzed using statistical regression analysis. RESULTS Only the range of motion of the coupled flexion-extension motion component, the ratio and the time shift between main axial rotation and coupled lateral bending motion components could be predicted for about 52%, 49% and 73%, respectively, by a selected set of anatomical features. CONCLUSION Supposed relationships between anatomical features and joint kinematics are only partially confirmed. The results indicate that the kinematics of the atlanto-axial joint during manual regional axial mobilization are not completely predetermined by the specimens' specific anatomy.
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Affiliation(s)
- E Cattrysse
- Department of Experimental Anatomy, Building B, Arthrokinematics Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Belgium.
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Cattrysse E, Provyn S, Kool P, Clarys JP, Roy PV. Reproducibility of global three-dimensional motion during manual atlanto-axial rotation mobilization: an in vitro study. J Man Manip Ther 2010; 18:15-21. [PMID: 21655419 DOI: 10.1179/106698110x12595770849489] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
The reproducibility of the three-dimensional (3D) kinematic aspects of motion coupling patterns during manual mobilizing techniques is still a debatable matter. The present in vitro study analysed segmental 3D motion of the atlanto-axial joint during manual axial rotation mobilization. Twenty fresh frozen human cervical specimens were studied in a test-retest situation with two examiners. The specimens were manually mobilized using three different techniques: (1) a regional mobilization technique of the cervical spine; (2) a segmental mobilization technique of the atlas with manual fixation of the axis; and (3) a segmental mobilization of the atlas on the axis applying a locking technique. Segmental atlanto-axial kinematics was registered with a Zebris CMS-20 ultrasound-based tracking system. The Euclidian norm was used as a representation of overall 3D motion. The results indicated good reproducibility (mean intraclass correlation coefficient, ICC: 0.87). Intraobserver reproducibility was slightly higher (mean ICC: 0.91; range: 0.76-0.99) than interobserver reproducibility (mean ICC: 0.85; range: 0.56-0.98) (P < 0.05). The total range of motion expressed as the Euclidean norm of 3D motion components was a parameter with good reproducibility in the study of segmental kinematics of manual atlanto-axial mobilization. Although previous studies have demonstrated poor inter-rater reliability of manual examination and mobilization of segmental motion components, the results of the present study shed a new and more positive light on the reproducibility of techniques for manual mobilization of the upper cervical spine.
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Affiliation(s)
- Erik Cattrysse
- Department of Experimental Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium
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