Open-design collar vs. Conventional Philadelphia collar regarding user satisfaction and cervical range of motion in asymptomatic adults

Abstract

Cervical collars are often prescribed to minimize physiologic loads and movements between the head and thorax by limiting cervical motion; they are also used for supporting a patient's head and reducing the risk of cervical injury resulting from additional spinal movements. One of the problems in orthotic treatment is the unpleasant appearance of the orthosis, which could impede the patient from continuing treatment. Currently, it is essential to consider the importance of the psychologic effect of rehabilitative treatment. The current study aimed to compare the Philadelphia collar and an open-design cervical collar with regard to user satisfaction and cervical range of motion in asymptomatic adults. Seventy-two healthy subjects (36 women, 36 men) aged 18 to 29 years were recruited for this study. Neck movements, including active flexion, extension, right/left lateral flexion, and right/left axial rotation, were assessed in each subject under 3 conditions—without wearing a collar and while wearing 2 different cervical collars—using a dual digital inclinometer. Subject satisfaction was assessed using a 5-item self-administered questionnaire. Both Philadelphia and open-design collars significantly reduced cervical motions ( P < 0.05). Compared with the Philadelphia collar, the open-design collar more greatly reduced cervical motions in three planes and the differences were statistically significant expects for limiting flexion. Satisfaction scores for Philadelphia and open-design collars were 15.89 ± 3.87 and 19.94 ± 3.11, respectively. This study demonstrated that the open-design collar is more cosmetically acceptable as a semirigid cervical collar compared with the Philadelphia collar, at least for subjects aged under forty years, while it also has optimal restriction potential. Further studies are needed to investigate its effectiveness in restricting cervical intervertebral motion and long-term compliance.