Three-dimensional motion analysis of the 2nd cervical spinous process at end range cervical rotation in different scapular positions using 3D digitizer

T Otsudo,H Hattori,K Akasaka,Y Hasebe,A Tamura

doi:10.1016/j.rehab.2018.05.1292

Abstract

It has been reported that passive elevation of the scapulae significantly decreases neck pain and increases cervical range of motion. However, it is unknown whether upper cervical rotation is influenced by different scapula positions or not. The study used a 3D digitizer to determine three-dimensional motion analysis of the 2nd cervical (C2) spinous process at end range cervical rotation with the scapula in different positions. 30 healthy adults (21.2 ± 0.8 years) participated in this study. Different scapula positions were adopted bilaterally and passively placed at (1) normal resting position, (2) depression, (3) adduction (4) abduction, with a neutral gleno-humeral joint in sitting. Under each scapula position, bilateral end range cervical rotation (degree) and displacement of the C2 spinous process [mm] were analyzed by a 3D digitizer device. End range rotation was analyzed by the vector from the left to right mastoid of the occipital bone related to the vector from the left to right acromial angle. Displacement of the C2 spinous process was calculated as the change in distance between the mastoid process and the point of intersection from perpendicular line from the C2 spinous process to the line between both mastoids at neutral and end range of cervical rotation. The results of our study indicate that there were no significant differences between end range cervical rotation and displacement of the C2 spinous process relative to the occiput in any scapular position. However, displacement of the C2 spinous process relative to the occiput was significantly correlated with range of cervical rotation under all scapular positions ( P < 0.05). Flexibility of upper cervical rotation would be influenced on end range cervical rotation regardless of scapular positions.

Highlights

Neck pain has considerable impact on societal health, representing 14.6% of all musculoskeletal problems reported annually [1]
These results indicated that C2 displacement was correlated with the magnitude of upper cervical rotation regardless of the four scapular positions: rest, depression, adduction, and abduction
The current study’s results support these physical therapies for people with cervicogenic headache (CGH) because there were no significant differences in range of cervical rotation and displacement of C2 spinous process relative to the occiput in any scapular position

Summary

Introduction

Neck pain has considerable impact on societal health, representing 14.6% of all musculoskeletal problems reported annually [1]. Assessment of active cervical spine movement is a routine part of examination of cervical spine disorders including neck pain [2]. Changes in the alignment of the scapulae can potentially influence the biomechanics of cervical spine by altering tension in these muscles [8]. There is disagreement in the literature about the effects of scapula position on cervical movement and pain. Passive scapular elevation significantly decreased neck pain and significantly increased cervical range of motion [9]. Another report found that scapula position did not influence range of cervical rotation [7]. It is unclear whether cervical rotation is influenced by different scapular positions or not

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Discussion

Conclusion