Mobility in the cervico-thoracic motion segment: an indicative factor of musculo-skeletal neck-shoulder pain.

The aim of the study was first to evaluate whether mobility in the cervico-thoracic motion segment is an indicative factor of musculo-skeletal neck-shoulder pain and secondly to compare differences in individual factors between cases and controls for female and male subjects. One-hundred-and-forty-two male electricians and 139 female laundry workers participated in a cross-sectional study. An examination of the Cervico-Thoracic Ratio and a classification of mobility at level C7-T1 was done. All subjects answered a questionnaire about musculo-skeletal complaints. The analysis of relationship between relative flexion mobility in motion segments C7-T5 and neck-shoulder pain showed significant relationships between mobility in specific motion segments and neck-shoulder pain. The overall fit of the multiple regression analysis explained 10% of the variation in neck index (N1) for subjects classified as hypomobile at level C7-T1 and 18% for subjects classified as having an inverse C7-T1 function. Both female and male subjects classified as hypomobile at level C7-T1 showed elevated odds ratios of 2.7 and 2.2, respectively, to have had more than 7 days of neck pain during the previous 12 months, compared to subjects classified as having ordinary mobility at level C7-T1. The factor age showed that young subjects with hypoar hypermobility at level C7-T1 showed elevated odds ratios for neck pain compared to subjects with ordinary mobility in the same age group. In old subjects hypermobility at level C7-T1 was protective compared to subjects with ordinary mobility in the same age group. The factor number of working years showed significant difference between cases and controls among female subjects in the ordinary and hypermobile classes. The factor height showed no significant differences between female or male cases and controls; it did show significant correlation to C7-T1 mobility among female subjects, but not among male subjects. The factors exercise and smoking showed significant differences between cases and controls among female subjects in the ordinary mobility class. The conclusion was that relative flexion mobility is a factor related to the development of neck-shoulder pain rather than the cause of pain.

A clinical method for measuring segmental flexion mobility in the cervico-thoracic spine and a model for classification.

Pain and limitation of spinal mobility are symptoms frequently reported by patients. Many methods have been used to assess the total range of mobility in the different parts of the spine, but there is no method for clinical examination of segmental mobility. The aim of this study was to describe such a technique concerning of segmental flexion mobility in the cervico-thoracic spine, C7-T5, and to present a model for classification of mobility. The results of this study show that the relative flexion mobility examined, according to the Cervico-Thoracic-Ratio technique (CTR), may become a valuable complement to conventional methods of assessing mobility in the cervical spine. The normalized CTR values are less influenced by the individual factors age, body weight, height and number of years at work and the classification model presented makes functional analysis of segmental flexion mobility in the cervico-junction and upper thoracic spine more substantial.

A clinical method for measuring the distribution of segmental flexion mobility in the cervico-thoracic spine.

The aim of this study was to evaluate the validity and the repeatability of a new technique to assess segmental flexion mobility in the cervico-thoracic spine between segments C7 and T5. The new technique is referred to as the Cervico-Thoracic-Ratio (the CTR-technique). The radiological evaluation of skin distraction measurements showed that validity was high for the CTR-technique. A high correlation between vertebral flexion mobility and skin distraction was recognized individually and for the whole group. The evaluation of repeatability was found to be high for intratester and fair for intertester repeatability. The CTR-technique may become a valuable complement to other methods for assessing segmental flexion mobility in patients suffering from neck-shoulder pain in clinical practice.