The global end-ranges of neck flexion and extension do not represent the maximum rotational ranges of the cervical intervertebral joints in healthy adults - an observational study.
Chiropr Man Therap
; 29(1): 18, 2021 05 25.
Article
en En
| MEDLINE
| ID: mdl-34034773
ABSTRACT
BACKGROUND:
In clinical diagnosis, the maximum motion of a cervical joint is thought to be found at the joint's end-range and it is this perception that forms the basis for the interpretation of flexion/extension imaging studies. There have however, been representative cases of joints producing their maximum motion before end-range, but this phenomenon is yet to be quantified.PURPOSE:
To provide a quantitative assessment of the difference between maximum joint motion and joint end-range in healthy subjects. Secondarily to classify joints into type based on their motion and to assess the proportions of these joint types. STUDYDESIGN:
This is an observational study. SUBJECT SAMPLE Thirty-three healthy subjects participated in the study. OUTCOMEMEASURES:
Maximum motion, end-range motion and surplus motion (the difference between maximum motion and end-range) in degrees were extracted from each cervical joint.METHODS:
Thirty-three subjects performed one flexion and one extension motion excursion under video fluoroscopy. The motion excursions were divided into 10% epochs, from which maximum motion, end-range and surplus motion were extracted. Surplus motion was then assessed in quartiles and joints were classified into type according to end-range.RESULTS:
For flexion 48.9% and for extension 47.2% of joints produced maximum motion before joint end-range (type S). For flexion 45.9% and for extension 46.8% of joints produced maximum motion at joint end-range (type C). For flexion 5.2% of joints and for extension 6.1% of joints concluded their motion anti-directionally (type A). Significant differences were found for C2/C3 (P = 0.000), C3/C4 (P = 0.001) and C4/C5 (P = 0.005) in flexion and C1/C2 (P = 0.004), C3/C4 (P = 0.013) and C6/C7 (P = 0.013) in extension when comparing the joint end- range of type C and type S. The average pro-directional (motion in the direction of neck motion) surplus motion was 2.41° ± 2.12° with a range of (0.07° -14.23°) for flexion and 2.02° ± 1.70° with a range of (0.04°-6.97°) for extension.CONCLUSION:
This is the first study to categorise joints by type of motion. It cannot be assumed that end-range is a demonstration of a joint's maximum motion, as type S constituted approximately half of the joints analysed in this study.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Vértebras Cervicales
/
Rango del Movimiento Articular
Tipo de estudio:
Observational_studies
Límite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Chiropr Man Therap
Año:
2021
Tipo del documento:
Article
País de afiliación:
Dinamarca