Cervical Spine Range Of Motion Research Articles

Barriers and Facilitators Associated With Remote Concussion Physical Assessments From the Perspectives of Clinicians and People Living With Workplace Concussions: Focus Group Study.

Evaluating the clinical status of concussions using virtual platforms has become increasingly common. While virtual approaches to care are useful, there is limited information regarding the barriers and facilitators associated with a virtual concussion assessment. This study aims to identify the barriers and facilitators associated with engaging in virtual concussion assessments from the perspective of people living with workplace concussions; identify the barriers and facilitators to completing virtual concussion assessments from the perspectives of clinicians; and identify the clinical measures related to 4 clinical domains that would be most appropriate in virtual practice: general neurological examination and vestibular, oculomotor, and cervical spine assessment. We also evaluated effort. Separate online focus groups were conducted with expert concussion clinicians and people living with workplace concussions. A moderator led the focus groups using a semistructured interview guide that targeted a discussion of participants' experiences with virtual assessments. The discussions were recorded, transcribed, and analyzed by 2 reviewers using content analysis. Barriers and facilitators associated with completing the physical concussion examination were categorized based on the domain of the concussion examination and more general barriers and facilitators. Clinician-selected measures believed to work best in a virtual practice were described using frequency counts. A total of 4 focus groups with 15 people living with workplace concussions and 3 focus groups with 14 clinicians were completed using Microsoft Teams. Barriers were identified, such as triggering of symptoms associated with completing an assessment over video (mentioned 13/162 (8%) and 9/201 (4%) of the time for patient and clinician participants, respectively); challenges with location and setup (mentioned 16/162 (10%) of the time for patient participants); communication (mentioned 34/162 (21%) and 9/201 (4%) of the time for patient and clinician participants, respectively); and safety concerns (mentioned 11/162 (7%) of the time for patient and 15/201 (7%) for clinician participants). Facilitators were identified, such as having access to support (mentioned 42/154 (27%) and 21/151 (14%) of the time for patient and clinician participants, respectively); implementing symptom management strategies throughout the assessment (mentioned 11/154 (7%) of the time for patient participants); and having access to resources (mentioned 25/151 (17%) of the time for clinician participants). From the perspective of the clinician participants included in this study, the clinical measures recommended most for a virtual practice were finger to nose testing; balance testing; the Vestibular/Ocular Motor Screening tool; saccades; and cervical spine range of motion within their respective domains (ie, neurological examination, vestibular, oculomotor, and cervical spine assessment). Virtual assessments appear to be useful for both people living with workplace concussions and clinicians. While barriers were identified, such as challenges associated with exposure to screens, virtual assessments have benefits such as improved access to care. The clinician-selected measures that were considered best in a virtual practice will be investigated in an upcoming evaluative study. RR2-10.2196/40446.

C1-ring оsteosynthesis as a functionally preserving operation for unstable atlas fractures

Objective. To analyze the dynamics of pain syndrome, quality of life and functional status of patients with unstable atlas fractures after C1-ring osteosynthesis.Material and Methods. Study design: observational retrospective case series study (n = 15). The intensity of pain syndrome was assessed using the VAS scale before surgery, 3 days, and 3 and 6 months after surgery. The quality of life was assessed using the Neck Disability Index (NDI) before surgery, and 3 and 6 months after surgery. Functional status, as well as cervical spine range of motion (head turn left/right, flexion/extension) was assessed 3 and 6 months after surgery. The integrity of the atlas bone ring and the degree of fusion after fixation were assessed using axial CT scans; and the lateral mass separation was assessed using frontal CT scans. The criterion for transverse ligament injury was a separation of lateral masses of more than 8.1 mm. Results. All patients had C1 fractures type 3B according to Gehweiler, out of them 7 patients (46.7 %) had traumatic injury to the atlas transverse ligament according to Dickman type 1, and 8 patients (53.3 according to Dickman type 2. The average age of patients was 40 years (12; 71), the male/female ratio was 2/1. In 7 patients (46.7 %), the cause of injury was diving, in 6 (40.0 %) it was a traffic accident, and in 2 (13.3 %) – a fall from a standing height. Observation of patients revealed a positive dynamics in the form of statistically significant regression of pain according to VAS before and 6 months after surgery from 6.8 (6.0; 8.0) to 1.0 (1.0; 0.0) points (Z = -3.434; p = 0.001). A positive trend was also noted in the form of a decrease in NDI scores and an improvement in the quality of life after 3 (Z = -3.411; p = 0.001) and 6 months after surgery (Z = -3.410; p = 0.001). The range of motion (turn left/right, flexion/extension) increased statistically significantly by the 6th month after C1-ring osteosynthesis, and its indicators were close to physiological ones. Postoperative CT scans showed positive dynamics in the form of statistically significant regression of the lateral mass separation from 10.4 mm (8.9; 11.4) to 2.2 mm (1.8; 2.6); Z = -3.408; p = 0.001. Complete fusion of the atlas fracture was observed after 12.5 months (8.5; 16.5).Conclusion. Isolated posterior osteosynthesis of the atlas ring for Gehweiler type 3B injury using a repositioning compression maneuver under distraction conditions is physiologically justified. It is a reliable method of stabilization, ensures the restoration of congruence and the entire range of motion in the atlanto-occipital and atlantoaxial joints and stability of the occipital-atlantoaxial complex. This operation contributes to a considerable and long-term reduction in the intensity of pain syndrome and a significant improvement in the quality of life.

Clinician-Prioritized Measures to Use in a Remote Concussion Assessment: Delphi Study.

There is little guidance available, and no uniform assessment battery is used in either in-person or remote evaluations of people who are experiencing persistent physical symptoms post concussion. Selecting the most appropriate measures for both in-person and remote physical assessments is challenging because of the lack of expert consensus and guidance. This study used expert consensus processes to identify clinical measures currently used to assess 5 physical domains affected by concussion (neurological examination, cervical spine, vestibular, oculomotor, or effort) and determine the feasibility of applying the identified measures virtually. The Delphi approach was used. In the first round, experienced clinicians were surveyed regarding using measures in concussion assessment. In the second round, clinicians reviewed information regarding the psychometric properties of all measures identified in the first round by at least 15% (9/58) of participants. In the second round, experts rank-ordered the measures from most relevant to least relevant based on their clinical experience and documented psychometric properties. A working group of 4 expert clinicians then determined the feasibility of virtually administering the final set of measures. In total, 59 clinicians completed survey round 1 listing all measures they used to assess the physical domains affected by a concussion. The frequency counts of the 146 different measures identified were determined. Further, 33 clinicians completed the second-round survey and rank-ordered 22 measures that met the 15% cutoff criterion retained from round 1. Measures ranked first were coordination, range of motion, vestibular ocular motor screening, and smooth pursuits. These measures were feasible to administer virtually by the working group members; however, modifications for remote administration were recommended, such as adjusting the measurement method. Clinicians ranked assessment of coordination (finger-to-nose test and rapid alternating movement test), cervical spine range of motion, vestibular ocular motor screening, and smooth pursuits as the most relevant measures under their respective domains. Based on expert opinion, these clinical measures are considered feasible to administer for concussion physical examinations in the remote context, with modifications; however, the psychometric properties have yet to be explored. RR2-10.2196/40446.

Reliability and Sensitivity of a Virtual Assessment Developed for Workplace Concussions: Protocol for a Method-Comparison Study.

Workplace mild traumatic brain injuries are frequently associated with persistent symptoms, leading to a reduction in productivity at work or even disability. People who sustain workplace injuries frequently need rehabilitation and support, and the challenges of delivering these services was heightened during the COVID-19 pandemic as injured workers had to be cared for remotely. Currently, clinicians are conducting both in-person and virtual (remote) concussion assessments; however, the measures that are being used to complete these assessments have undocumented psychometric properties. This study will document the psychometric properties of the clinical measures that are being used remotely and their ability to produce similar results to in-person assessments. Specifically, through this method-comparison study, we aim to (1) evaluate the sensitivity of the measures included in a virtual assessment toolkit when compared to an in-person assessment and (2) determine the interrater and intrarater reliabilities of the measures included in a virtual assessment toolkit. Patient participants (people living with acquired brain injuries) will attend two assessments (in person and virtual) at the Ottawa Hospital. The two assessments will be identical, consisting of the measures included in our previously developed virtual concussion assessment toolkit, which includes finger-to-nose testing, the Vestibular/Ocular Motor Screening tool, balance testing, cervical spine range of motion, saccades testing, and evaluation of effort. All virtual assessments will occur using the Microsoft Teams platform and will be audio/video-recorded. The clinician assessor and patient participant will complete a feedback form following completion of the assessments. A different clinician will also document the findings on observed videos of the virtual assessment shortly after completion of both in-person and virtual assessments and approximately 1 month later. Interrater reliability will be assessed by comparing the second clinician's observation with the first clinician's initial virtual assessment. Intrarater reliability will be evaluated by comparing the second clinician's observation with their own assessment approximately 1 month later. Sensitivity will be documented by comparing the findings (identification of abnormality) of the in-person assessment completed by the initial clinician assessor with those of the second clinician assessor on the observation of the recording of the virtual assessment. As of May 2024, we have recruited 7 clinician assessors and completed study assessments with 39 patient participants. The study recruitment is expected to be completed by September 2024. Currently, it is unknown if completing concussion assessments virtually produces similar results to the in-person assessment. This work will serve as a first step to determining the similarity of the virtual assessment to the matching in-person assessment and will provide information on the reliability of the virtual assessment. DERR1-10.2196/57663.

The preservation of cervical flexibility helps maintain cervical sagittal alignment after laminoplasty

BACKGROUND CONTEXTCervical spine range of motion (ROM) is a critical factor in changes in cervical sagittal alignment (CSA) and clinical outcomes after cervical laminoplasty (LMP). However, the impact of postoperative cervical ROM on CSA after cervical LMP is still unclear. PURPOSEEvaluating the imaging and symptomatic data from patients with cervical spondylotic myelopathy (CSM) to identify the influence of postoperative cervical ROM on post-LMP CSA and surgical outcomes. STUDY DESIGNRetrospective study. PATIENT SAMPLEEighty-six patients undergoing LMP due to multilevel CSM OUTCOME MEASURESRadiographic parameters were measured before surgery and at follow-up: cervical lordosis (CL), T1 slope (T1S), cervical sagittal vertical axis (cSVA), CL in flexion (Flex CL), CL in extension (Ext CL), total cervical spine range of motion (ROM), cervical spine range of flexion (Flex ROM), and cervical spine range of extension (Ext ROM). Japanese Orthopedic Association (JOA) and visual analog score (VAS) were used to assessed clinical outcomes. Other parameters included age, gender, body mass index (BMI), follow-up time, number of surgical segments, proximal level, distalis level, and collar wear time. METHODSWe divided patients according to the changes in CSA (loss of cervical lordosis (LCL)>10°, or ≤10°; an increase in cervical sagittal vertical axis (I-cSVA) >10mm, or ≤10mm). A receiver-operating characteristic curve (ROC) analysis was constructed to identify the optimal cut-off value to discriminate the patients with and without postoperative deterioration of CSA. RESULTSThe postoperative total and Flex ROM were significantly lower in the LCL>10° and I-cSVA>10mm groups. Multivariate logistic regression analysis showed that low post-Flex ROM was significant risk factor for postoperative deterioration of CSA. ROC showed that the cut-off value for postoperative Flex ROM was 15.60°. Improvements in JOA recovery rate and neck pain were more significant in the flexibility group (post-Flex ROM ≥15.6°) after surgery. Patients in the stiffness group (post-Flex ROM <15.6°) wore a collar longer. CONCLUSIONSThe preservation of cervical flexibility can maintain CSA after cervical LMP. Postoperative cervical stiffness is related to poor surgical outcomes because significant cervical kyphotic change and sagittal imbalance are likely to occur after surgery. Prolonged wearing of cervical collar is correlated with cervical stiffness following cervical LMP.

Myofascial release for adults with chronic neck pain and depression

BackgroundDepression affects a significant portion of the global adult population, with chronic pain patients being particularly susceptible to severe depression. Pain and mental illness contribute to an imbalance in the autonomic nervous system, affecting heart function. Myofascial release promises to improve mental and physical health by addressing fascial dysfunctions. ObjectiveThis study aims to investigate the influence of myofascial release on emotional states and autonomic nervous system functioning in individuals with chronic neck pain and depression. Additionally, it seeks to evaluate the myofascial release effect on fascial properties, pain intensity and sensitivity, and cervical spine range of motion. MethodExperimental Study. ResultThe study revealed significant enhancements in the myofascial release group, such as a substantial reduction in pain perception and stiffness, increased range of motion of the cervical spine, heart rate variability, positive affect, and pressure pain threshold. The effect sizes of these improvements ranged from small to large. No significant differences were observed in elasticity and tone. ConclusionThe findings suggest that myofascial release has a positive impact on individuals with chronic neck pain and depression, particularly in reducing pain intensity. Integrating myofascial release into treatment approaches may be beneficial. However, further research is needed to confirm and expand upon these findings, explore long-term effects, and better understand the clinical significance of certain outcomes. Trial registrationhttp://www.osf.io, doi.org/10.17605/OSF.IO/6F5RS

Change of cervical flexion range of motion influences postoperative sagittal alignment of the cervical spine after laminoplasty

ObjectiveThe relationships between preoperative cervical spine range of motion (ROM) and postoperative cervical sagittal alignment (CSA), and clinical outcomes after laminoplasty (LMP) have been widely studied. However, the impact of ROM changes on postoperative CSA and clinical outcomes after LMP remains unclear. Herein, patients with cervical spondylotic myelopathy (CSM) were retrospectively analyzed to explore the association between postoperative cervical ROM changes and CSA and surgical outcomes.MethodsPatients who underwent cervical LMP at our hospital between January 2019 to June 2022 were retrospectively reviewed. CSA parameters were measured before the surgery and at the final follow-up. Loss of cervical lordosis (LCL) was defined as preoperative cervical lordosis (CL) - postoperative CL. An increase in the cervical sagittal vertical axis (I-cSVA) was defined as postoperative cervical sagittal vertical axis (cSVA) - preoperative cSVA. We defined the changes in cervical flexion range of motion (△Flex ROM, preoperative Flex ROM minus postoperative Flex ROM) > 10° as L- Flex ROM group, and △Flex ROM ≤ 10° as S- Flex ROM group. Japanese Orthopedic Association (JOA) score and visual analog score (VAS) were used to assess the surgical outcomes.ResultsThe study comprised 74 patients and the average follow-up period was 31.83 months. CL, total ROM, and Flex ROM decreased and cSVA increased after cervical LMP. LCL and I-cSVA were positively correlated with △Flex. Multiple linear regression analysis showed that a decrease in the Flex ROM was a risk factor for LCL and I-cSVA after LMP. LCL and I-cSVA were higher in the L-Flex ROM group than in the S-Flex ROM group. Postoperative JOA and the JOA recovery rate were worse in the L-Flex ROM group than in the S-Flex ROM group.ConclusionsCervical total and Flex ROM decreased after cervical LMP. The reduction of Flex ROM was associated with LCL and I-cSVA after surgery. The preservation of cervical Flex ROM helps maintain CSA after LMP. Therefore, more attention should be paid to maintaining cervical ROM to obtain good CSA and surgical effects after cervical LMP.

Disc Degeneration and Cervical Spine Intervertebral Motion: A Cross-Sectional Study in Patients with Neck Pain and Matched Healthy Controls.

While neck pain can be defined in clinical terms, in most cases the underlying pathophysiology is largely unknown. Regional cervical spine range of motion is often found to be reduced in patients with neck pain compared to persons without pain although it is not clear if the decreased range is cause or effect. Less is known about the role of intervertebral kinematics and how that might be related to the presence of disc degeneration. In this study, the prevalence of intervertebral disc degeneration and continuous cervical intervertebral motion were both measured utilizing quantitative fluoroscopy (QF) in patients with subacute or chronic neck pain (n = 29) and gender-matched healthy controls (n = 30). A composite disc degeneration (CDD) score was calculated for each participant from the first, neutral, lateral fluoroscopic image. Intervertebral motion sharing parameters of motion-sharing inequality (MSI) and motion-sharing variability (MSV) were derived from the active cervical motion sequences obtained while patients were seated. The objective was to determine if average age, CDD, MSI, and MSV values were correlated and if there were differences in these variables between the neck pain group and the healthy control group. Correlation analysis was conducted for age, CDD, MSI, and MSV in each group. Age was moderately correlated with MSV in cervical spine extension in patients only (r = 0.63, p < 0.001). There were no significant differences in the prevalence of disc degeneration (CDD) between patients, who had on average mild pain and related disability, and healthy controls (median CDD 2 both groups, p = 0.94). There were also no significant differences in either flexion or extension intervertebral motion-sharing inequality or variability (MSI or MSV) between groups as measured during active cervical motion.

Laminectomy alone versus laminectomy with lateral mass screw fixation in the treatment of multisegment cervical spinal canal stenosis: a comparative analysis

BackgroundMultisegment cervical canal stenosis is one of the most common causes of spinal cord dysfunction. Cervical laminectomy affords direct relief from dorsal stenosis, but many concerns were raised regarding its effect on spinal stability and cervical sagittal alignment. Laminectomy in conjunction with lateral mass screws is aiming to prevent recurrence of stenosis and to achieve much improvement of the cervical spine range of motion and curvature.ObjectivesTo compare the clinical and radiological outcome of laminectomy alone versus laminectomy with lateral mass screw fixation in the treatment of patients with multisegment cervical canal stenosis.Patients and methodsA retrospective study conducted on 46 patients with multisegment cervical canal stenosis who were treated between April 2018 and April 2021. Patients were divided into two groups. The 20 cases in group (A) underwent conventional laminectomies and the 26 cases in group (B) underwent laminectomies with lateral mass screw fixation. Operative complications, visual analogue scale (VAS), neurological functional recovery and cervical curvature changes were compared between the two groups.ResultsOperative times in group A were significantly less than it was in group B (P < 0.001). The postoperative VAS scores in group B were significantly lower than those in group A (P < 0.05). No statistical differences in the modified Japanese Orthopedic Association score could be found between the two groups after surgery. Patients in group B in comparison with those in group A had good alignment of the cervical spine with maintenance of curvature index (P < 0.001).ConclusionsIn multilevel cervical canal stenosis, internal fixation using lateral mass screws in conjunction with laminectomy can be of a considerable significance than laminectomy alone in improving the axial symptoms and ceasing further disease progression through stabilization of the cervical spine and maintaining the sagittal alignment.

A Biomechanical Investigation of Cervical Spine Range of Motion for UH-60 Aviators in Real and Simulated Flight Environments.

Military flight surgeons evaluating aviators for flight fitness based on the cervical spine range of motion (CROM) have no operationally relevant reference with which to make a reliable determination. The published physiological limits for the general population do not necessarily apply to military aviators. CROM requirements for rotary-wing aviators would ideally be defined by measurements taken directly within their operational environment. Nine subjects performed the same predetermined 1-hour flight mission in a UH-60 aircraft and then, at least 2 days later, in the U.S. Army Aeromedical Research Laboratory (USAARL) NUH-60 flight simulator. Head position was recorded using an optical-based inertial tracker attached to the night vision goggle mount of the subjects' flight helmets. Matched-pair t-tests were implemented to compare the maximum CROM between aircraft and simulated flights and the published general population. The percent of flight time in severe flexion and lateral bending was not statistically different (P > 0.05) between real and simulated flights but was statistically lower in the simulator for severe twist rotation (P < 0.05). The maximum CROM for the advanced maneuvers was significantly lower than the norms for the general population (P < 0.05). The flight simulator could be a useful platform for flight surgeons determining CROM-related flight fitness if methods to increase the frequency of neck twist rotation movements during flight were implemented. The published maximum CROM values for the general population are not an appropriate reference for flight surgeons making flight fitness determinations related to CROM.

EFFECTIVENESS OF KALTENBORN MOBILIZATION TECHNIQUE VERSUS CONVENTIONAL EXERCISE FOR SUBJECTS WITH CERVICAL SPONDYLOSIS

BACKGROUND &amp; AIM: The application of joint mobilization to the upper thoracic spine has been reported to have an positive effect, sometimes immediately, on cervical spine dysfunction, in conjunction with the provision of pain relief. However, previous including joint mobilization, have been ineffective in a busy clinical setting because they involve the direct and passive intervention of therapists. So the purpose of this study is to evaluate the effectiveness of kaltenborn mobilization technique among cervical spondylosis. OBJECTIVE: • To determine the effectiveness of kaltenborn mobilization technique on reducing pain by using VAS • To evaluate the effectiveness of kaltenborn mobilization technique on improving cervical spine range of motion (ROM) by using goniometer. METHOD: STUDY DESIGN: experimental study SAMPLING TECHNIQUE: Convenient sampling technique SAMPLE SIZE: 30 RESULT: Statistical study revealed that among 30 individuals, The test shows that the subjects received kaltenborn mobilization along with interferential therapy have improved reduction in pain and increased in ROM among cervical spondylosis. CONCLUSION: From this results it has been concluded that there was a definite and positive effect of Kaltenborn mobilization technique along with Interferential therapy for cervical spondylosis patients. KEYWORDS: kaltenborn mobilization, goniometer, cervical spondylosis, isometric exercises.

Cervical Range of Motion Assessment through Inertial Technology: A Validity and Reliability Study

Inertial technology has spread widely for its comfortable use and adaptability to various motor tasks. The main objective of this study was to assess the validity of inertial measurements of the cervical spine range of motion (CROM) when compared to that of the optoelectronic system in a group of healthy individuals. A further aim of this study was to determine the optimal placement of the inertial sensor in terms of reliability of the measure, comparing measurements obtained from the same device placed at the second cervical vertebra (C2), the forehead (F) and the external occipital protuberance (EOP). Twenty healthy subjects were recruited and asked to perform flexion–extension, lateral bending, and axial rotation movements of the head. Outcome measurements of interest were CROM and mean angular velocities for each cervical movement. Results showed that inertial measurements have good reliability (0.75 &lt; ICC &lt; 0.9). Excellent reliability (ICC &gt; 0.9) was found in both flexion and right lateral bending angles. All parameters extracted with EOP placement showed ICC &gt; 0.62, while ICC &lt; 0.5 was found in lateral bending mean angular velocities both for F and C2 placements. Therefore, the optimal sensor’s positioning emerged to be EOP. These results suggest that inertial technology could be useful and reliable for the evaluation of the CROM.

The relationship between cervical spine range of motion and postural sway in mechanical neck pain: A cross-sectional study.

Impairments in postural sway have been identified in people with mechanical neck pain. The influence of cervical spine range of motion (ROM) on postural sway is unclear in mechanical neck pain (MNP). This study investigated the relationship between cervical spine range of motion (ROM) and postural sway in MNP. The cervical ROM was measured using the Cervical Range of Motion (CROM) device. Standing postural sway characterised by mean centre of pressure (COP) measurements in the anterior posterior (AP) and medio-lateral direction with eyes closed and feet together condition was recorded on a posturography platform. Pearson product moment correlation coefficient was used to identify the relationship between cervical ROM and postural sway. Seventy-two MNP individuals (Mean age: ) of either sex (Male: ) were recruited. Overall, no statistically significant correlations were identified between cervical spine ROM in sagittal and frontal plane and postural sway (r values ranging from 0.00 to ; p-values ). However, a weak negative correlation was present between the cervical rotation and AP (r-; p-) and mediolateral (r-; p-) COP excursion. The cervical spine ROM was found to have a weak relationship with postural sway in individuals with MNP. This suggests the investigation of other mechanisms especially muscle tension which might be responsible for altered postural sway in MNP.

Functional range of motion of the cervical spine in cervical fusion patients during activities of daily living

Following cervical spine fusion there is a reduction in maximum range of motion (ROM) but how this impacts activity of daily living (ADLs) and quality of life is unknown. This study’s purpose is to quantify maximum and functional cervical spine ROM in patients with multi-level cervical fusion (>3 levels) compared to controls during ADLs and to correlate functional range of motion with scores from patient reported outcomes measures (PROs) including the Comparative Pain Scale (CPS), Fear Avoidance Belief Questionnaire (FABQ), and Neck Disability Index (NDI).An inertial measurement unit (IMU) system quantified ROM during ADLs in the extension/flexion, lateral bending, and axial rotation directions of motion. The reliability of this system was compared to standard optical motion tracking. Fourteen participants (8 females, age = 60.0 years (18.7) (median, (interquartile range)) with a history of multi-level cervical fusion (years post-op 0.9 (0.7)) were compared to 16 controls (13 females, age = 52.1 years (15.8)). PROs were collected for each participant.Fusion participants had significantly decreased maximum ROM in all directions of motion. Fusion participants had decreased ROM for some ADLs (backing up a car, using a phone, donning socks, negotiating stairs). CPS, FABQ, and NDI scores were significantly increased in fusion participants. Reductions in two activities (backing up a car, stair negotiation) correlated with a combination of increased PRO scores.Cervical fusion decreases maximum ROM and is correlated with increased PROs in some ADLs, however there is minimal impact on functional ROM. Investigation into velocity and acceleration may yield categorization of pathologic movement.

Preoperative Range of Motion in Extension May Influence Postoperative Cervical Kyphosis After Laminoplasty.

Retrospective observational study. The objective of this study was to investigate factors associated with cervical kyphosis after laminoplasty. Many factors are reportedly associated with the deterioration of cervical curvature after laminoplasty, including cervical lordosis angle, cervical spine range of motion (ROM), T1 slope, and C2-C7 sagittal vertical axis. Postlaminoplasty kyphosis or deterioration of cervical curvature is likely caused by multiple factors. There is currently no consensus on these issues. Data of patients treated with laminoplasty for degenerative cervical myelopathy at our institution during 2008-2018 were reviewed. The following variables were collected for each patient: age and sex; follow-up time; surgery involving C3 (yes or no); surgery involving C7 (yes or no); distribution of segments operated on; number of laminae operated on; flexion, extension, and total ROM; cervical lordotic angle; longitudinal distance index; curvature index; C2-C7 sagittal vertical axis; and T1 slope. Logistic regression analysis was used to assess possible risk factors for postoperative kyphosis. Receiver operating characteristic curves were constructed to determine the cutoff values of risk factors. The study cohort comprised 151 patients. Logistic regression analysis indicated that sex, number of laminae operated on, and preoperative extension ROM were significantly associated with postoperative cervical kyphosis ( P <0.05). There was significantly greater postoperative kyphosis in women than in men; the more segments operated on, the greater the risk of postoperative kyphosis, and the larger the preoperative extension ROM, the lower the risk of postlaminoplasty kyphosis. Receiver operating characteristic curve analysis showed that the cutoff value for preoperative extension ROM is 22.1°. Preoperative extension ROM may be associated with the development of postoperative kyphosis. The cutoff value of preoperative extension ROM that suggested the prospect of postoperative kyphosis in our sample was 22.1°.

Outcomes of massage and acupressure therapy in taking care of patients with shoulder-neck strain syndrome at The Military institute of Traditional Medicine in 2022

Objectives: To describe the outcomes of massage and acupressure therapy in taking care of patients with shoulder-neck strain syndrome at the Military Institute of Traditional medicine in 2022. Methods: Cross-sectional descriptive design was performed on 170 patients. Treatment results were assessed by the following contents: pain level, cervical spine range of motion, and daily activity level. Results: the rate of patients with muscle spasticity in the neck and back on the first day of treatment was 91.2% and 82.65%, respectively; after 20 days of treatment were 24.12% and 6.77%, respectively. The difference was statistically significant with p&lt;0.05. After 20 days of treatment, most patients had mild pain 0 &lt; VAS ≤ 2 (74.2%). The amplitude of the cervical spine increased, and the range of motion of the cervical spine was improved (the rate of limitation of motion decreased from 15.33% to 0%). Conclusion: The therapy of massage and acupressure significantly affects patients with neck and shoulder pain.

Association between Age, Sex and Cervical Spine Sagittal Plane Motion: A Descriptive and Correlational Study in Healthy Volunteers

Active motion examination of patients with cervical spine-related pathologies is necessary to establish baseline function, set physical therapy goals, and choose interventions. This study investigated the sagittal plane active range of motion (ROM) of the global (GCS) and upper cervical spine (UCS) in relation to age and sex in healthy volunteers. One hundred twenty-two volunteers aged 18 to 75 years participated. Volunteers were excluded if they displayed any characteristic that could affect cervical spine ROM. GCS and UCS flexion and extension were each measured three times using a CROM device. Linear regression models (LRMs) were developed to explore the relationships between age and sex and GCS and UCS ROM. The LRM for age showed a decrease in GCS flexion (-2.01°), GCS extension (-3.33°), and UCS extension (-1.87°) for every decade of increasing age. The LRM for sex showed that men displayed less ROM than women in GCS extension (-6.52°) and UCS extension (-2.43°). These results suggest an age-related loss of sagittal plane GCS ROM and UCS extension ROM, and sex-related differences in GCS and UCS extension with women having greater motion than men.

Improvement of cervical spine mobility and stance stability by wearing a custom-made mandibular splint in male recreational athletes.

The range of motion (ROM) of the cervical spine and postural stability are important for an economical and motorically adequate adaptation of the body to any situation. Therefore, this study aims to analyze whether these two components of postural and movement control can be influenced by means of a splint in a centric position compared to habitual occlusion. 38 recreational male athletes volunteered. Cervical spine ROM was recorded using an ultrasound system and the a pressure measuring plate for postural stability (length of center of pressure (CoP) movement, area of CoP). The two dental occlusion conditions employed were the habitual occlusion and wearing a splint in an idealized, condylar position close to the centric position. Level of significance was set at ρ ≤ 0.05. The cervical spine mobility increased significantly by wearing the splint regarding rotation to the left (+3.9%) and right (+2.7%) and lateral flexion to the left (+4.4%) and right (+6.7%). Wearing the splint reduced the area of sway deflections by about 31.5% in the bipedal stance and by about 2.4% (left) and 28.2% (right) in the unipedal stance. The CoP trace was reduced in the sagittal plane by approximately 8.2% in the right single-leg stance. The major findings seem to demonstrate that wearing a splint that keeps the jaw close to the centric relation may increase the cervical ROM and may improve balance stability in male recreational athletes. Changing the jaw relation in athletes can possibly aid the release of performance potentials by improving coordination skills.

Balance Stability and Cervical Spine Range of Motion While Wearing a Custom-Made Mandibular Splint with Special Consideration of the Sex

Introduction: An altered dental occlusion can also affect balance stability or mobility. Thus, the aim of this study was to examine whether wearing a mandibular splint, which retains the occlusion close to the centric occlusion, can increase or decrease balance stability and the range of motion (ROM) of the cervical spine as opposed to the habitual occlusion, and if there is a difference between men and women. Material and methods: In this study, 41 male (34.7 ± 11.4 years) and 50 female subjects (29.3 ± 12.7 years) participated. Cervical spine ROM was recorded using the Zebris CMS 70P system. For balance stability, a pressure measuring platform integrated into the treadmill system (FDM-T) of the company Zebris® Medical GmbH was used. Here, the area of the ellipse and the length of the Center of Pressure (CoP) was recorded whilst in the bipedal and unipedal stance. Results: The sex comparison showed significant differences for the area of the ellipse of the right leg and ROM extension in the habitual occlusion: females showed a better balance stability and a larger ROM extension. When wearing the splint, only the CoP of the left leg was significant with a better balance stability in female subjects. Within the male subjects, the ellipse area in the bipedal and unipedal (left/right) stance showed mostly significant reductions, while the rotation left and right as well as the lateral flexion (left/right) improved when wearing the splint. Female subjects, when wearing the splint, showed a significant decrease of the ellipse area and the CoP length when standing on either leg. Flexion, rotation to the right and lateral flexion to the left/right, all increased significantly. Conclusion: Wearing a splint that keeps the jaw close to the centric relation improved balance stability and increased the ROM of the cervical spine for both male and female subjects. Women may have marginally different basic balance stability strategies than men, with regard to bipedal and unipedal standing. Nevertheless, there are scarcely any differences between the two sexes in the adaptation when wearing a splint. Changing the jaw relation in healthy adults can possibly support the release of movement potentials that simplify the performance of everyday activities or sports movements.

Development and testing of a new application for measuring motion at the cervical spine

BackgroundCervical myelopathy is a progressive disease, and early detection and treatment contribute to prognosis. Evaluation of cervical intervertebral instability by simple X-ray is used in clinical setting and the information about instability is important to understand the cause of myelopathy, but evaluation of the intervertebral instability by X-ray is complicated. To reduce the burden of clinicians, a system that automatically measures the range of motion was developed by comparing the flexed and extended positions in the lateral view of a simple X-ray of the cervical spine. The accuracy of the system was verified by comparison with spine surgeons and residents to determine whether the system could withstand actual use.MethodsAn algorithm was created to recognize the four corners of the vertebral bodies in a lateral cervical spine X-ray image, and a system was constructed to automatically measure the range of motion between each vertebra by comparing X-ray images of the cervical spine in extension and flexion. Two experienced spine surgeons and two residents performed the study on the remaining 23 cases. Cervical spine range of motion was measured manually on X-ray images and compared with automatic measurement by this system.ResultsOf a total of 322 cervical vertebrae in 46 images, 313 (97%) were successfully estimated by our learning model. The mean intersection over union value for all the 46-test data was 0.85. The results of measuring the CRoM angle with the proposed cervical spine motion angle measurement system showed that the mean error from the true value was 3.5° and the standard deviation was 2.8°. The average standard deviations for each measurement by specialist and residents are 2.9° and 3.2°.ConclusionsA system for measuring cervical spine range of motion on X-ray images was constructed and showed accuracy comparable to that of spine surgeons. This system will be effective in reducing the burden on and saving time of orthopedic surgeons by avoiding manually measuring X-ray images.Trial registration Retrospectively registered with opt-out agreement.