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Liu M, Quarrington RD, Sandoz B, Robertson WSP, Jones CF. Evaluation of Apparatus and Protocols to Measure Human Passive Neck Stiffness and Range of Motion. Ann Biomed Eng 2024; 52:2178-2192. [PMID: 38658477 PMCID: PMC11247060 DOI: 10.1007/s10439-024-03517-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
Understanding of human neck stiffness and range of motion (ROM) with minimal neck muscle activation ("passive") is important for clinical and bioengineering applications. The aim of this study was to develop, implement, and evaluate the reliability of methods for assessing passive-lying stiffness and ROM, in six head-neck rotation directions. Six participants completed two assessment sessions. To perform passive-lying tests, the participant's head and torso were strapped to a bending (flexion, extension, lateral bending) or a rotation (axial rotation) apparatus, and clinical bed, respectively. The head and neck were manually rotated by the researcher to the participant's maximum ROM, to assess passive-lying stiffness. Participant-initiated ("active") head ROM was also assessed in the apparatus, and seated. Various measures of apparatus functionality were assessed. ROM was similar for all assessment configurations in each motion direction except flexion. In each direction, passive stiffness generally increased throughout neck rotation. Within-session reliability for stiffness (ICC > 0.656) and ROM (ICC > 0.872) was acceptable, but between-session reliability was low for some motion directions, probably due to intrinsic participant factors, participant-apparatus interaction, and the relatively low participant number. Moment-angle corridors from both assessment sessions were similar, suggesting that with greater sample size, these methods may be suitable for estimating population-level corridors.
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Affiliation(s)
- Mingyue Liu
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, SA, Australia
- Adelaide Spinal Research Group, Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Ryan D Quarrington
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, SA, Australia
- Adelaide Spinal Research Group, Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Baptiste Sandoz
- Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, Paris, France
| | - William S P Robertson
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, SA, Australia
| | - Claire F Jones
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, SA, Australia.
- Adelaide Spinal Research Group, Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.
- Department of Orthopaedics & Trauma, Royal Adelaide Hospital, Adelaide, SA, Australia.
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Analysis of time-space variations during dynamic cervical spine motion in cervical spondylosis myelopathy patients. Spine J 2022; 22:1857-1865. [PMID: 35760320 DOI: 10.1016/j.spinee.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/06/2022] [Accepted: 06/16/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Decreased cervical range of motion (ROM) is a common symptom of myelopathy patients. Many previous studies have relied on a variety of experimental approaches for quantifying static cervical range of motion. However, the change rules of time-space variation during dynamic cervical spine motion remains unknown. PURPOSE To develop and validate the effectiveness of a novel wearable robot-based sensor system, Analysis of Dynamic Cervical spine Motion (ADCM), in evaluating the dynamic cervical spine motion dysfunction of patients with cervical spondylotic myelopathy (CSM). STUDY DESIGN/SETTING A cross-sectional study. PATIENT SAMPLE One hundred forty consecutive healthy individuals (70 men and 70 women) and 120 CSM patients (60 men and 60 women) were enrolled in the present study. OUTCOME MEASURES The cervical motion process parameters, including the flexion and extension ROM, the flexion and extension time, and the Japanese Orthopedic Association scores (JOA) for cervical spine were measured. METHODS Two hundred and sixty consecutive participants were asked to wear ADCM system and then fully flex and extend their neck rapidly and evenly at tolerable maximum speed. The cervical motion process was recorded and converted into waveforms. Relevant waveform parameters were measured and analyzed. The number of complete flexion-extension motions in 10 seconds has been defined as 10s F-E cycles. The Japanese Orthopedics Association (JOA) scores of CSM patients were marked. RESULTS CSM patients had a lower number of 10s F-E cycles than healthy subjects. There were significant differences in flexion and extension time and ROM between two groups. The waveforms of myelopathy patients were wider and lower than those in healthy individuals. The average ratio value (defined as F) of wave height to wave width (a+b/c+d) could quantitatively reflect such differences of waveforms. The average F value was correlated with the JOA scores of the cervical motion function (r=0.7538), and F value declined as JOA scores decreased. According to receiver operating characteristic curve analysis, the optimal threshold value of the normal average ratio was more than 34.7. CONCLUSIONS ADCM appears to be an objective and quantitative severity assessment tool for confirmed CSM patients by evaluating dynamic cervical spine motion dysfunction.
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Tueth LE, Duncan RP. Musculoskeletal pain in Parkinson's disease: a narrative review. Neurodegener Dis Manag 2021; 11:373-385. [PMID: 34410146 PMCID: PMC8515213 DOI: 10.2217/nmt-2021-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/09/2021] [Indexed: 11/21/2022] Open
Abstract
The prevalence of musculoskeletal (MSK) pain in people with Parkinson's disease (PD) is higher than that of age-matched controls. In this review, we outline what is known about MSK pain in PD, focusing on the neck, shoulder, knee, hip and low back. We also compare what is known about MSK pain in PD to what is known in older adults without PD. Finally, we outline areas of for future research related to MSK pain in people with PD.
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Affiliation(s)
- Lauren Elizabeth Tueth
- Program in Physical Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO 63108, USA
| | - Ryan P Duncan
- Program in Physical Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO 63108, USA
- Department of Neurology, School of Medicine, Washington University in St. Louis, St. Louis, MO 63108, USA
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Schmitt M, Vogt L, Wilke J, Niederer D. Unilateral and bilateral training competitive archers differ in some potentially unhealthy neck-shoulder region movement behaviour characteristics. BMC Sports Sci Med Rehabil 2021; 13:44. [PMID: 33902697 PMCID: PMC8077866 DOI: 10.1186/s13102-021-00272-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 04/15/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Excessive unilateral joint loads may lead to overuse disorders. Bilateral training in archery is only performed as a supportive coordination training and as a variation of typical exercise. However, a series of studies demonstrated a crossover transfer of training-induced motor skills to the contralateral side, especially in case of mainly unilateral skills. We compared the cervical spine and shoulder kinematics of unilateral and bilateral training archers. METHODS In this cross-sectional study, 25 (5 females, 48 ± 14 years) bilaterally training and 50 age-, sex- and level-matched (1:2; 47.3 ± 13.9 years) unilaterally training competitive archers were included. Cervical range of motion (RoM, all planes) and glenohumeral rotation were assessed with an ultrasound-based 3D motion analysis system. Upward rotation of the scapula during abduction and elevation of the arm were measured by means of a digital inclinometer and active shoulder mobility by means of an electronic caliper. All outcomes were compared between groups (unilaterally vs. bilaterally) and sides (pull-hand- vs. bow-hand-side). RESULTS Unilateral and bilateral archers showed no between group and no side-to-side-differences in either of the movement direction of the cervical spine. The unilateral archers had higher pull-arm-side total glenohumeral rotation than the bilateral archers (mean, 95% CI), (148°, 144-152° vs. 140°, 135°-145°). In particular, internal rotation (61°, 58-65° vs. 56°, 51-61°) and more upward rotation of the scapula at 45 degrees (12°, 11-14° vs. 8°, 6-10°), 90 degrees (34°, 31-36° vs. 28°, 24-32°), 135 degrees (56°, 53-59° vs. 49°, 46-53°), and maximal (68°, 65-70° vs. 62°, 59-65°) arm abduction differed. The bow- and pull-arm of the unilateral, but not of the bilateral archers, differed in the active mobility of the shoulder (22 cm, 20-24 cm vs. 18 cm, 16-20 cm). CONCLUSIONS Unilaterally training archers display no unphysiologic movement behaviour of the cervical spine, but show distinct shoulder asymmetris in the bow- and pull-arm-side when compared to bilateral archers in glenohumeral rotation, scapula rotation during arm abduction, and active mobility of the shoulder. These asymmetries in may exceed physiological performance-enhancing degrees. Bilateral training may seems appropriate in archery to prevent asymmetries.
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Affiliation(s)
- Mareike Schmitt
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Ginnheimer Landstraße 39, D-60487, Frankfurt am Main, Germany
| | - Lutz Vogt
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Ginnheimer Landstraße 39, D-60487, Frankfurt am Main, Germany
| | - Jan Wilke
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Ginnheimer Landstraße 39, D-60487, Frankfurt am Main, Germany
| | - Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Ginnheimer Landstraße 39, D-60487, Frankfurt am Main, Germany.
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Artificial intelligence prediction of the effect of rehabilitation in whiplash associated disorder. PLoS One 2020; 15:e0243816. [PMID: 33332408 PMCID: PMC7746175 DOI: 10.1371/journal.pone.0243816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 11/18/2020] [Indexed: 12/29/2022] Open
Abstract
The active cervical range of motion (aROM) is assessed by clinicians to inform their decision-making. Even with the ability of neck motion to discriminate injured from non-injured subjects, the mechanisms to explain recovery or persistence of WAD remain unclear. There are few studies of ROM examinations with precision tools using kinematics as predictive factors of recovery rate. The present paper will evaluate the performance of an artificial neural network (ANN) using kinematic variables to predict the overall change of aROM after a period of rehabilitation in WAD patients. To achieve this goal the neck kinematics of a cohort of 1082 WAD patients (55.1% females), with mean age 37.68 (SD 12.88) years old, from across Spain were used. Prediction variables were the kinematics recorded by the EBI® 5 in routine biomechanical assessments of these patients. These include normalized ROM, speed to peak and ROM coefficient of variation. The improvement of aROM was represented by the Neck Functional Holistic Analysis Score (NFHAS). A supervised multi-layer feed-forward ANN was created to predict the change in NFHAS. The selected architecture of the ANN showed a mean squared error of 308.07–272.75 confidence interval for a 95% in the Monte Carlo cross validation. The performance of the ANN was tested with a subsample of patients not used in the training. This comparison resulted in a medium correlation with R = 0.5. The trained neural network to predict the expected difference in NFHAS between baseline and follow up showed modest results. While the overall performance is moderately correlated, the error of this prediction is still too large to use the method in clinical practice. The addition of other clinically relevant factors could further improve prediction performance.
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Improving the staging of neck injuries using a new index, the Neck Functional Holistic Analysis Score: Clustering approach to determine degrees of impairment. PLoS One 2020; 15:e0238424. [PMID: 32903259 PMCID: PMC7480840 DOI: 10.1371/journal.pone.0238424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 08/17/2020] [Indexed: 11/24/2022] Open
Abstract
Background Traumatic cervical spine injuries are amongst the traffic injuries that can cause most harm to a person. Classifying subtypes of clinical presentations has been a method used in other pathologies to diagnose more efficiently and to address the appropriate treatment and the prognosis. The management of patients suffering from cervical injuries could be improved by classifying the severity of the impairment. This will allow clinicians to propose better treatment modalities according to the severity of the injury. Materials and methods The present study is a retrospective cohort study performed with the clinical data from 772 patients stored at Fisi-(ON) Health Group. All the patients treated for cervical spine injuries are evaluated using the EBI-5® system, which is based on inertial measurement unit (IMU) technology. The normalized range of motion of each patient was incorporated into a single index, the Neck Functional Holistic Analysis Score (NFHAS). Results Clustering analysis of the patients according to their NFHAS resulted in five groups. The Kruskal-Wallis H test showed that there were statistically relevant differences in the ROM values and NFHAS of the patients depending on the cluster they were assigned to: FE X2(4) = 551.59, p = 0.0005; LB ROM X2(4) = 484.58, p = 0.0005; RT ROM X2(4) = 557.14, p = 0.0005; NFHAS X2(4) = 737.41, p = 0.0005. Effect size with ηp2 for the comparison of groups were: FE = 0.76, LB = 0.68, RT = 0.76 and NFHAS = 0.96. Conclusion The NFHAS is directly correlated to the available ROM of the patient. The NFHAS serves as a good tool for the classification of cervical injury patients. The degree of impairment shown by the cervical injury can now be staged correctly using this new classification.
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Langenfeld A, Bohlender JE, Swanenburg J, Brockmann-Bauser M. Cervical Spine Disability in Correlation with Subjective Voice Handicap in Patients With Voice Disorders: A Retrospective Analysis. J Voice 2018; 34:371-379. [PMID: 30553599 DOI: 10.1016/j.jvoice.2018.10.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Neck muscle dysfunction has been considered as risk factor or consequence of voice disorders. This study investigates the correlation between neck and voice-related subjective symptoms in patients with voice disorders. STUDY DESIGN Retrospective case-control study. METHODS 100 adult patients (59 female and 41 male) over 18 years with a mean age of 50.01 years (SD 16, range 24-87), of which 68 were under 60 years, were included. 50 patients had organic voice pathologies and 50 functional dysphonia. Outcome measures were the Voice Handicap Index 9 international (VHI-9i) and the Neck Disability Index (NDI-G). Spearman rank order coefficient was applied to determine the correlation between overall and single item VHI and NDI results. Subanalyses were done for functional vs. organic disorder, gender and age ± 60 years. RESULTS Mean overall VHI-9i (13.93, SD = 7.81, range = 0-31) and mean NDI-G (6.07, SD = 7.71, range = 0-43) showed a significant mild correlation (rs = 0.220, P = 0.02). Split into subgroups the relation was stronger in patients with organic pathologies (rs = 0.297, P = 0.03), but not significant in functional disorders (r = 0.148, P = 0.30). There was a moderate relation in men (rs = 0.317, P = 0.04). Single item correlation was highest between VHI-9i item P4 (physiological) and NDI-G item reading (cognitive functioning) (rs = 0.480, P = 0.002). CONCLUSION Specifically patients with organic voice disorders showed increased voice symptoms with the presence of neck dysfunction. This indicates a risk for a functional imbalance of the muscles surrounding the larynx, which in extreme cases may hinder functional voice rehabilitation even after phonosurgery. Therefore, neck dysfunction should be considered in voice diagnostics.
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Affiliation(s)
- Anke Langenfeld
- Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Integrative Spinal Research ISR, Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland
| | - Jörg E Bohlender
- Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jaap Swanenburg
- Physiotherapy Occupational Therapy Research, Directorate of Research and Education, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Integrative Spinal Research ISR, Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland
| | - Meike Brockmann-Bauser
- Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Jull G, Hall T. Cervical musculoskeletal dysfunction in headache: How should it be defined? Musculoskelet Sci Pract 2018; 38:148-150. [PMID: 30270129 DOI: 10.1016/j.msksp.2018.09.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 09/13/2018] [Accepted: 09/20/2018] [Indexed: 02/08/2023]
Abstract
Neck pain commonly accompanies migraine and tension-type headache, but the literature is divided on whether this neck pain is a headache symptom or is associated with cervical musculoskeletal dysfunction. Clarification is essential for hypotheses on the pathogenesis of these headaches and their variants and for decisions on suitability of local neck treatments, both from research and clinical practice perspectives. Reasons for disparate findings could relate to participant selection in headache studies and/or the bases on which decisions on the presence of cervical musculoskeletal dysfunction are reached. Propositions towards gaining a clearer picture of migraine and tension-type headache related neck pain include first, stricter inclusion criteria and reporting of headache characteristics of study participants. Second, reliance on pain sensitivity or the presence of neck tenderness/trigger points as measures be discarded, as they are not uniquely tied to a musculoskeletal disorder. Instead, place reliance on tests of musculoskeletal (dys)function. Third, the values and interpretation of single measures or tests of impairment/dysfunctions can be non-informative and do not reflect the presentation of cervical musculoskeletal disorders. Rather, a typical presentation includes at a fundamental level, interrelated changes in cervical movement, segmental joint and muscle function. We advocate that these measures be adopted as the core set of related measures to define cervical musculoskeletal dysfunction in headache. This does not deter inclusion of other measures of interest or qualification.
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Affiliation(s)
- Gwendolen Jull
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia.
| | - Toby Hall
- School of Physiotherapy and Exercise Science, Curtin University, Australia.
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Abstract
STUDY DESIGN Mixed-method. OBJECTIVE To evaluate the association between objective and subjective cervical range of motion (ROM) among patients with neck pain, and to assess the awareness of impairments. SUMMARY OF BACKGROUND DATA Cervical ROM is frequently used to evaluate neck pain, but it is also important to know what a patient expects from treatment, because this can profoundly affect treatment outcomes and patient satisfaction. METHODS We used a cervical ROM instrument, the Neck Disability Index (NDI), and a self-administered ROM questionnaire for the neck (S-ROM-Neck). Ten patients took part in semi-structured interviews. Correlations were analyzed using Spearman rank order correlations (rs). Differences between patient and assessor were evaluated by the Mann-Whitney U test. Qualitative data were analyzed by content analysis. RESULTS Thirty participants (mean age 43.80 years; 21 females) were included. The correlation (rs) for the S-ROM-Neck between patient and assessor was 0.679 [95% confidence interval (95% CI) 0.404-0.884; P = 0.000]. The correlation between the NDI and S-ROM-Neck was 0.178 (95% CI -0.233 to -0.533; P = 346) for the assessor and -0.116 (95% CI -0.475 to -0.219, P = 0.541) for the patient (U = 448, z = -0.030, P = 0.976). Qualitative analysis revealed that patients had general restrictions in daily life and with specific movements, but that they adjusted their behavior to avoid impairment. CONCLUSION There was a significant correlation between patient and therapist ratings of cervical spine mobility. Although patients experience restriction while moving and are impaired in specific activities, they adjust their lifestyle to accommodate their limitations. LEVEL OF EVIDENCE 4.
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The effect of age and sex on the cervical range of motion – A systematic review and meta-analysis. J Biomech 2018; 75:13-27. [DOI: 10.1016/j.jbiomech.2018.04.047] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 04/23/2018] [Accepted: 04/26/2018] [Indexed: 11/20/2022]
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Reliability of measuring half-cycle cervical range of motion may be increased using a spirit level for calibration. Musculoskelet Sci Pract 2018; 33:99-104. [PMID: 28869199 DOI: 10.1016/j.msksp.2017.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 08/10/2017] [Accepted: 08/21/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Assessments of range of motion (ROM) represent an essential part of clinical diagnostics. Ultrasonic movement analyses have been demonstrated to provide reliable results when analyzing complete amplitudes (e.g., flexion-extension). However, due to subjective determination of the starting position, the assessment of half-cycle movements (e.g, flexion only) is less reproducible. OBJECTIVES The present study aimed to examine the reliability of measuring half-cycle cervical ROM using a spirit level for calibration. METHOD 20 healthy subjects (30 ± 12yrs, 7♂, 13♀) participated in the randomized, controlled, cross-over trial. In two testing sessions with one week of wash-out in between, cervical ROM was measured by means of an ultrasonic 3D movement analysis system using a test-retest design (baseline and 5 min post baseline). The sessions differed with reference to the mask carrying the ultrasound markers. It was removed during the 5 min break (mask off) or not (mask on). To determine the resting position, a bull's eye spirit level was used in each measurement. RESULTS With ICC values of 0.90-0.98 (mask on, p < 0.001) and 0.90 to 0.97 (mask off, p < 0.001), both examined conditions demonstrated excellent test-retest reliability for separating the cycles regarding all movement planes. CONCLUSION Cervical ROM during half-cycle movements can be assessed with excellent reliability using a spirit level. In contrast to subjective determination of the starting position, analyzing complete movement planes does not increase reliability. Using a defined and objective zero positioning allows the evaluation of repositioning tasks.
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Niederer D, Vogt L, Vogel J, Banzer W. Effects of dual-task conditions on cervical spine movement variability. J Back Musculoskelet Rehabil 2017; 30:1075-1080. [PMID: 28505961 DOI: 10.3233/bmr-169699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The potential to accurately perform cervical movements during more challenging tasks might be of importance to prevent dysfunctional motion characteristics. Although sensorimotor function during dual-task conditions are of increasing interest in biomedical and rehabilitation research, effects of such conditions on movement consistency of the neck have not yet been investigated. OBJECTIVE In this crossover MiSpEx(Medicine in Spine Exercise)-diagnostic study, we aimed to explore differences between single and dual-task conditions on cervical movement variability. METHODS Nineteen healthy participants (9 male; 24.5 ± 3.3 y) performed 10 repetitive maximal cervical movements in (1) flexion/extension and (2) lateral flexion, during one single- and during two dual-task test conditions (cognitive, motor) in a randomised and cross-over sequence. Latter consisted of a working memory n-back task (n= 2) and a repetitive ankle movement task. Range of motion (RoM) was assessed using an external three-dimensional ultrasonic movement analysis system. Coefficient of variation (CV) for repetitive RoM was analysed for differences between conditions and controlled for variances in intra-individual movement characteristics. RESULTS Friedman and post-hoc Bonferroni-adjusted confidence intervals for differences from single- to dual-task values revealed changes in CV in flexion/extension from single-task to motor dual-task (+0.02 ± 0.02 (97.5%CI: 0.01; 0.03); p< 0.05) but not to cognitive dual-task condition (+0.01 ± 0.02 (97.5%CI: 0.003; 0.02)) nor for lateral flexion (p> 0.05). Pearson regression analyses revealed a linear negative (p< 0.01) influence of CV in flexion/extension on differences from single to both cognitive (R=2 0.47) and motor dual-task (R=2 0.55). Results for lateral flexion are comparable, baseline CV negatively impacts differences to cognitive (R=2 0.2) and motor dual-task performance (R=2 0.76; p< 0.01). CONCLUSIONS Participants with comparable low cervical CV at single-task display a profound increase during dual-task conditions while participants with a higher variability remained almost stable or showed a decrease. The results point toward a complex interrelationship of motion patterns and adaptation processes during challenging tasks in respect of cervical CV.
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Wachowski MM, Weiland J, Wagner M, Gezzi R, Kubein-Meesenburg D, Nägerl H. Kinematics of cervical segments C5/C6 in axial rotation before and after total disc arthroplasty. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 26:2425-2433. [DOI: 10.1007/s00586-017-5073-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/28/2017] [Accepted: 03/27/2017] [Indexed: 10/19/2022]
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On the relevance of surrogate parameter deduction in biomedical research: mediated regression analysis for variance explanation of cervical range of motion. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 26:162-166. [PMID: 27324088 DOI: 10.1007/s00586-016-4658-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 03/23/2016] [Accepted: 06/14/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Research on cervical range of motion (ROM) often includes age and body mass index (BMI) as potential variables to explain inter-individual variances. The BMI may not be a predictor of ROM but an age-affected surrogate parameter: the described effect of BMI on ROM is, thus, suspected being partially or completely mediated by age. METHODS Healthy and adult volunteers (n = 139, 65 female, age 19-75 years, BMI 24.2 ± 3.8 kg m-2) performed five repetitive maximal cervical movements in the sagittal plane to assess maximal ROM (primary outcome). After the examination of underlying assumptions, data were analysed by mediation regression analyses using a SPSS-macro provided by Hayes. ROM represented the outcome variable, independent variable was BMI and mediator variable was age. Total as well as direct and indirect effects were calculated: (1) for all subjects included and (2) for subject with a BMI <35 kg m-2. RESULTS Analysis including all subjects revealed both a direct (-1.1, s e .46, p < .05, 95 %CI -2; -1.7) and an existing indirect effect (mediated by age, -2.4, s e .33, p < .05, 95 %CI -3.1; -1.8) of BMI on ROM. Analysis without obese 2 subjects showed no direct effect of BMI (effect -1, s e .54, p > .05, 95 %CI -2.1; +.1) but a systematic indirect effect, mediated by age, on ROM (effect -2.4, s e .33, p < .001, 95 %CI -3.1; -1.8). CONCLUSIONS After the withdrawal of the surrogate parameter BMI, age explains 53 % of maximal ROM. No impact of BMI on ROM was detected after excluding highly obese participants. Our results illustrate the relevance of including each supposable predictor in causal mediation models development.
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Wilke J, Niederer D, Vogt L, Banzer W. Remote effects of lower limb stretching: preliminary evidence for myofascial connectivity? J Sports Sci 2016; 34:2145-2148. [PMID: 27124264 DOI: 10.1080/02640414.2016.1179776] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The skeletal muscles and the fibrous connective tissue form an extensive, body-wide network of myofascial chains. As fascia can modify its stiffness, strain transmission along these meridians is supposable. The goal of this trial therefore was to collect pilot data for potential remote effects of lower limb stretching on cervical range of motion (ROM). Twenty-six healthy participants (30 ± 6 years) were included in the matched-pairs intervention study. One group (n = 13) performed three 30 s bouts of static stretching for the gastrocnemius and the hamstrings, respectively. An age- and sex-matched control group (CG; n = 13) remained inactive. Pre- and post-intervention, maximal cervical ROM in flexion/extension was assessed. A repeated measures ANOVA revealed systematic differences between groups (P < .05). ROM increased following stretching (143.3 ± 13.9 to 148.2 ± 14°; P < .05) but remained unchanged in the CG (144.6 ± 16.8 to 143.3 ± 16.8°; P > .05). Our data point towards existence of a strain transfer along myofascial meridians. Further randomised controlled studies on conditions, factors and magnitude of tensile transmission are warranted.
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Affiliation(s)
- Jan Wilke
- a Department of Sports Medicine , Goethe University Frankfurt/Main , Frankfurt/Main , Germany
| | - Daniel Niederer
- a Department of Sports Medicine , Goethe University Frankfurt/Main , Frankfurt/Main , Germany
| | - Lutz Vogt
- a Department of Sports Medicine , Goethe University Frankfurt/Main , Frankfurt/Main , Germany
| | - Winfried Banzer
- a Department of Sports Medicine , Goethe University Frankfurt/Main , Frankfurt/Main , Germany
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Neck motion kinematics: an inter-tester reliability study using an interactive neck VR assessment in asymptomatic individuals. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 25:2139-48. [DOI: 10.1007/s00586-016-4388-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 01/11/2016] [Accepted: 01/15/2016] [Indexed: 11/26/2022]
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Niederer D, Vogt L, Pippig T, Wall R, Banzer W. Local Muscle Fatigue and 3D Kinematics of the Cervical Spine in Healthy Subjects. J Mot Behav 2015; 48:155-63. [PMID: 26180902 DOI: 10.1080/00222895.2015.1058241] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The authors aimed to further explore the effects of local muscle fatigue on cervical 3D kinematics and the interrelationship between these kinematic characteristics and local muscle endurance capacity in the unimpaired cervical spine. Twenty healthy subjects (38 ± 10 years; 5 women) performed 2 × 10 maximal cervical flexion-extension movements. Isometric muscle endurance tests (prone/supine lying) were applied between sets to induce local muscle fatigue quantified by Borg scale rates of perceived exertion (RPE) and slope in mean power frequency (MPF; surface electromyography; m. sternocleidomastoideus, m. splenius capitis). Cervical motion characteristics (maximal range of motion [ROM], coefficient of variation of the 10 repetitive movements, mean angular velocity, conjunct movements in transversal and frontal plane) were calculated from raw 3D ultrasonic movement data. Average isometric strength testing duration for flexion and extension correlated to the cervical ROM (r = .49/r = .48; p < .05). However, Student's t test demonstrated no significant alterations in any kinematic parameter following local muscle fatigue (p > .05). Although subjects' cervical muscle endurance capacity and motor output seems to be conjugated, no impact of local cervical muscle fatigue on motor function was shown. These findings underline the importance of complementary measures to address muscular performance and kinematic characteristics in outcome assessment and functional rehabilitation of the cervical spine.
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Affiliation(s)
- Daniel Niederer
- a Department of Sports Medicine , Goethe-University Frankfurt/Main , Germany
| | - Lutz Vogt
- a Department of Sports Medicine , Goethe-University Frankfurt/Main , Germany
| | - Torsten Pippig
- b Department of Clinical Aviation Medicine , German Air Force Institute for Aviation Medicine , Fürstenfeldbruck , Germany
| | - Rudolf Wall
- a Department of Sports Medicine , Goethe-University Frankfurt/Main , Germany
| | - Winfried Banzer
- a Department of Sports Medicine , Goethe-University Frankfurt/Main , Germany
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