Cervical Rotation Range Of Motion Research Articles

Comparative Effectiveness of Muscle Energy Technique and Static Stretching for Treatment of Subacute Mechanical Neck Pain

Background: Neck pain is a common problem within our society. Upper trapezius and the levator scapulae are the most common postural muscles that tends to get shorten leading to restricted neck mobility. If these group of muscles are treated it may provide with best results. There is lack of evidence to allow conclusions to be drawn about the effectiveness of Muscle energy technique (MET) when compared with stretching exercises for relieving mechanical neck pain. It would be interesting to study if these two techniques yield comparable outcomes and if one technique is superior to the next which should be the alternate choice of therapy . Objective: To evaluate the comparative effectiveness of Muscle energy technique and static stretching on pain and active cervical range of motion (ROM) in subacute mechanical neck pain Subjects and methods: 45 patients with subacute mechanical neck pain were randomly assigned to receive Muscle Energy Technique plus conventional physiotherapy (group 1, n = 15), static stretching plus conventional exercise program (group 2, n = 15) and conventional physiotherapy only (group 3, n = 15). Intervention: Group 1 received 6 sessions of Muscle Energy Technique and 10 sessions of conventional physiotherapy. Group 2 received 6 sessions of static stretching and 10 sessions of conventional physiotherapy. Group 3 received 10 sessions of conventional physiotherapy. All groups were treated for 2 weeks. Outcome measures: Pain intensity on 100mm VAS, active cervical lateral flexion range of motion, active cervical rotation range of motion. Results: Paired t-test was used for within group analysis. ANOVA followed by post hoc analysis was employed for between group comparisons. No significant difference was found in any of the outcome measure between MET and static stretching groups (p > 0.05) while both were found to be significantly better than the conventional exercise group (p < 0.05) between the 3 groups. Statistically significant improvements were found in all the 3 groups for all the outcome measures (p < 0.05). Conclusion: This study concluded that both the treatment techniques, muscle energy technique and static stretching were effective in alleviating the mechanical neck pain in terms of decreasing pain intensity and increasing active cervical range of motion as there was no significant difference between the two groups, however MET was superior than static stretching in decreasing pain intensity and increasing active cervical range of motion.

Influence of Scapular Position on Cervical Rotation Range of Motion

Cross-sectional study, quasi-experimental design. To compare the active cervical rotation range of motion (ROM) between healthy young subjects with a neutral vertical scapular alignment and subjects with scapular depression, and to examine the influence of modifying the vertical position of the scapulae on active cervical rotation ROM. Altered scapular alignment is proposed to be related to neck dysfunction and pain. Changes in the alignment of either the scapulae or the cervical spine can potentially influence the biomechanics of the other by altering the tension at the cervicoscapular muscles. Fifty-eight college age students with neutral vertical scapular alignment (NS group, n = 29) or depressed scapular alignment (DS group, n = 29) volunteered to participate in the study. Cervical rotation ROM was assessed using the CROM device in 2 conditions: condition 1, resting scapular position; condition 2, neutral vertical scapular position with forearms supported. The ANOVA revealed no significant group-by-condition interaction (F = 0.19, df = 1, P = .66). There was a significant main effect of condition (F = 47.16, df = 1, P<.001). For both groups, there was an increase in cervical rotation ROM in condition 2 when compared to condition 1 (mean +/- SD, 10.2 degrees +/- 3.1 degrees; 95% Cl: 4.1 degrees to 16.4 degrees). There was no main effect of group (F = .41, df = 1, P = .53). Our results suggest that in a young healthy population the vertical scapular alignment does not influence cervical rotation ROM. Supporting the upper limbs, however, results in a significant and similar increase in cervical rotation ROM for both groups.

The Immediate Effects of Upper Thoracic Translatoric Spinal Manipulation on Cervical Pain and Range of Motion: A Randomized Clinical Trial

This study examined the effect of translatoric spinal manipulation (TSM) on cervical pain and cervical active motion restriction when applied to upper thoracic (T1-T4) segments. Active cervical rotation range of motion was measured re- and post-intervention with a cervical inclinometer (CROM), and cervical pain status was monitored before and after manipulation with a Faces Pain Scale. Study participants included a sample of convenience that included 32 patients referred to physical therapy with complaints of pain in the mid-cervical region and restricted active cervical rotation. Twenty-two patients were randomly assigned to the experimental group and ten were assigned to the control group. Pre- and post-intervention cervical range of motion and pain scale measurements were taken by a physical therapist assistant who was blinded to group assignment. The experimental group received TSM to hypomobile upper thoracic segments. The control group received no intervention. Paired t-tests were used to analyze within-group changes in cervical rotation and pain, and a 2-way repeated-measure ANOVA was used to analyze between-group differences in cervical rotation and pain. Significance was accepted at p=0.05. Significant changes that exceeded the MDC95 were detected for cervical rotation both within group and between groups with the TSM group demonstrating increased mean (SD) in right rotation of 8.23° (7.41°) and le rotation of 7.09° (5.83°). Pain levels perceived during post-intervention cervical rotation showed significant improvement during right rotation for patients experiencing pain during bilateral rotation only (p=.05). This study supports the hypothesis that spinal manipulation applied to the upper thoracic spine (T1-T4 motion segments) significantly increases cervical rotation ROM and may reduce cervical pain at end range rotation for patients experiencing pain during bilateral cervical rotation.

Pilot study of impedance-controlled microcurrent therapy for managing radiation-induced fibrosis in head-and-neck cancer patients

Purpose : To evaluate the effectiveness of impedance-controlled microcurrent therapy for managing treatment sequelae in head-and-neck cancer patients. Methods and Materials : Between January 1998 and June 1999, 26 patients who were experiencing late effects of radiotherapy were treated b.i.d. with impedance-controlled microcurrent therapy for 1 week. Objective range-of-motion measurements were made for cervical rotation, extension/flexion, and lateral flexion before therapy, at the end of each treatment day, and monthly for 3 months. In addition, each patient’s subjective complaints were tabulated before treatment and reevaluated at the last follow-up visit. No additional physical therapy or electrical stimulation was permitted during the follow-up period. Results : At the end of the course of microcurrent therapy, 92% of the 26 patients exhibited improved cervical rotation, 85% had improved cervical extension/flexion, and 81% had improved cervical lateral flexion. Twenty-two patients returned for the 3-month follow-up visit. Of these, 91% had maintained a cervical rotation range of motion greater than their pretherapy measurements. Eighty-two percent maintained improved cervical extension/flexion and 77% maintained improved lateral flexion. When the range-of-motion measurements were stratified by pretreatment severity (severe, moderate, mild, or asymptomatic), the degree of improvement directly correlated with the severity. Thus, patients who had more severe initial symptoms experienced a higher percentage of improvement than did those with milder symptoms. For these patients, the cervical rotation range of motion changed from a baseline of 59° ± 12° to 83° ± 14° at 3 months; flexion/extension improved from 47° ± 10° to 73° ± 13°; and lateral flexion went from 31° ± 7° to 48° ± 9°. Some patients also reported symptom improvement for tongue mobility, facial asymmetry, xerostomia, cervical/facial muscle spasms, trismus, and soft tissue tenderness. No adverse effects were observed. Conclusion : Impedance-controlled microcurrent therapy shows promise for remediation of range-of-motion limitations arising as late effects of radiotherapy for head-and-neck cancer. Additional studies are needed to validate these preliminary results and to optimize the microcurrent treatment protocol, particularly with respect to treatment schedules and combining microcurrent therapy with physical and/or drug therapy.