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Klein J, Koch I, Delgadillo BE, Chickness J, Blank J, Amos A, Tay K, Kelly EA, Webber K, Benzinger B, Haft J, Miller D. Concussion Reduction in Division I and II Athletes: Effects of Simple Cervical Spine Exercise Regimen. Cureus 2024; 16:e66058. [PMID: 39229396 PMCID: PMC11370701 DOI: 10.7759/cureus.66058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Accepted: 08/03/2024] [Indexed: 09/05/2024] Open
Abstract
INTRODUCTION Primary preventative medicine lacks a consensus on effective concussion prevention strategies for collegiate athletes. Cervical strength has been identified as a potential factor in concussion risk reduction. This study evaluates the impact of a commercially available, portable cervical muscle stretching and strengthening device, NeckX®, on cervical strength, range of motion (ROM), and concussion incidence in collegiate athletes participating in high-concussion-risk sports. METHODS A single-arm prospective cohort study was conducted with 162 collegiate athletes from various sports. Participants underwent a 12-week neck exercise protocol using the NeckX® device. Clinical data, including neck strength and ROM, were collected at weeks 0, 6, and 12. Concussion incidence was self-reported by participants and cross-referenced with records from the athletic department. Data were analyzed for significant neck strength and ROM changes throughout the 12-week study. A two-way analysis of variance multiple comparisons with the Tukey-Kramer significant difference test was utilized, using the Holm-Sidak method, with an alpha of 0.05. RESULTS All athletic teams experienced a significant increase in cervical strength during the 12-week intervention (α = 0.05, p < 0.05). Increases in cervical flexion and extension force were most consistent between teams. Cervical ROM increased significantly in male and female soccer players (α = 0.05, p < 0.05). The overall incidence of head and neck injuries, including concussions, was reduced to 6.60% during the study period, the lowest recorded value in the university's athletic department history. CONCLUSION The use of the NeckX® device for 12 weeks was effective in enhancing pericervical muscle strength and ROM while reducing concussion incidence in collegiate athletes participating in high-concussion-risk sports. Interestingly, the positive outcomes were consistent for both males and females, indicating the universal advantages of neck training among collegiate athletes. These findings support existing research on the benefits of cervical strengthening exercises for reducing concussions in collegiate athletes and highlight the convenience and affordability of using this device.
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Affiliation(s)
- Joel Klein
- Physiatry, Rochester Regional Health, Rochester, USA
| | - Ian Koch
- Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Blake E Delgadillo
- Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Jason Chickness
- Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Jacob Blank
- Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Ashton Amos
- General Surgery, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Kevin Tay
- Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Emily A Kelly
- Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Kassidy Webber
- Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Brett Benzinger
- Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Jeffrey Haft
- Athletic Training, Mercyhurst University, Erie, USA
| | - Drew Miller
- Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Erie, USA
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Boyanmış AH, Kesilmiş İ, Akın M, Yilmaz B, Uslular A, Karac Ocal Y, Andre H. A Comparison of Different Strength Measurement in Taekwondo: Herman Trainer, Manual Tester, and Standing Long Jump. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:550. [PMID: 38674196 PMCID: PMC11052195 DOI: 10.3390/medicina60040550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/20/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
Background and Objective: The accurate prediction of strength development relies on identifying the most appropriate measurement methods. This study compared diverse strength measurement techniques to assess their effectiveness in predicting strength development. Participants were taekwondo athletes competing at the red-black belt level or above. Methods: Technical striking forces (palding, dollyeo chagi, dwit chagi, and yeop chagi) were measured using a Herman Digital Trainer fixed to a striking stand. Quadriceps and hamstring strength were assessed with a Lafayette force measuring device. Explosive leg strength was evaluated through a standing long jump test, normalized for leg length. The Pearson correlation coefficient was used to examine relationships between measurement methods. Results: The standing long jump test showed no significant correlation with other strength assessments. A moderate positive correlation was found between Herman digital trainer measurements and Lafayette digital hand-held dynamometer results. A high positive correlation (r = 0.736, p < 0.001) emerged between hamstring strength and palding chagi technical strike force results. Technical strike kicks showed a significant positive correlation with each other and, also, a right foot-left foot correlation was observed. Conclusions: It was concluded that the standing long jump test, which was shown as one of the explosive leg strength measurement methods in field studies as an alternative to laboratory tests, did not correlate with other strength tests; therefore, this test is weak and insufficient to predict strength skills in taekwondo. In addition, this study showed that the hamstring muscle was more predictive in the measurement of technical strength. In future studies, it might be more useful to measure hamstring muscle strength or technical kick strength instead of a standing long jump field test.
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Affiliation(s)
- Ayşe Hazal Boyanmış
- Faculty of Sports Sciences, Mersin University, Mersin 33110, Turkey; (İ.K.); (M.A.); (B.Y.)
| | - İnci Kesilmiş
- Faculty of Sports Sciences, Mersin University, Mersin 33110, Turkey; (İ.K.); (M.A.); (B.Y.)
| | - Manolya Akın
- Faculty of Sports Sciences, Mersin University, Mersin 33110, Turkey; (İ.K.); (M.A.); (B.Y.)
| | - Buse Yilmaz
- Faculty of Sports Sciences, Mersin University, Mersin 33110, Turkey; (İ.K.); (M.A.); (B.Y.)
| | - Aşina Uslular
- Faculty of Sports Sciences, Kütahya Dumlupınar University, Kütahya 43100, Turkey;
| | - Yesim Karac Ocal
- Faculty of Sports Sciences, Yozgat Bozok University, Yozgat 66200, Turkey; (Y.K.O.); (H.A.)
| | - Hulya Andre
- Faculty of Sports Sciences, Yozgat Bozok University, Yozgat 66200, Turkey; (Y.K.O.); (H.A.)
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Anwar S, Arsalan A, Zafar H, Ahmad A, Hanif A. Effects of breathing reeducation on cervical and pulmonary outcomes in patients with non specific chronic neck pain: A double blind randomized controlled trial. PLoS One 2022; 17:e0273471. [PMID: 36006997 PMCID: PMC9409509 DOI: 10.1371/journal.pone.0273471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 08/01/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The purpose of this randomized controlled trial was to study effects of breathing reeducation in the treatment of patients with non specific chronic neck pain. METHODS A total of sixty eight eligible patients with chronic neck pain were randomly allocated to breathing reeducation (BR) group (n = 34) and routine physical therapy (RPT) group (n = 34). Clinical outcomes were neck pain measured through visual analogue score, cervical active range of motion through CROM device, strength of neck muscles through hand held dynamometer and endurance of neck muscles measured through craniocervical flexion test. The neck disability was measured through neck disability index (NDI) and pulmonary outcomes such as forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC ratio were measured through Spirolab 4. The outcomes were assessed at baseline and at 4 and at 8 weeks from baseline. RESULTS There were significant improvements in the BR group compared with the RPT group (P = 0.002) for cervical flexion, extension (P = 0.029), endurance (P = 0.042), strength of neck flexors (P <0.001), neck extensors (P = 0.034). Likewise there was a significant change in NDI (P = 0.011), FEV1 (P = 0.045), FVC (P <0.001), and FEV1/FVC ratio (P <0.001) in the BR group compared with the RPT group. The cervical side flexion and rotation showed no significant difference in breathing reeducation group with p > 0.05. CONCLUSION Breathing reeducation combined with routine physical therapy is an effective treatment in patients with non specific chronic neck pain. TRIAL REGISTRATION IRCT 20200226046623N1, https://www.irct.ir/trial/46240.
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Affiliation(s)
- Sahreen Anwar
- Department of Physical Therapy, Independent Medical College Faisalabad, Faisalabad, Pakistan
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Asadullah Arsalan
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Hamayun Zafar
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ashfaq Ahmad
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Asif Hanif
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
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Fuller C, Falvey É, Schneider K. Reliability of a neck strength test in schoolboy rugby players. Musculoskelet Sci Pract 2022; 60:102566. [PMID: 35644049 DOI: 10.1016/j.msksp.2022.102566] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/24/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND In rugby union, a bracing mechanism of the neck and trunk is normally adopted in contact situations where high linear and angular forces are produced, which may contribute to the risk for sports-related concussion (SRC). OBJECTIVES To examine the feasibility of and test-retest reliability, both inter-rater and intra-rater reliability, of a novel neck strength test in schoolboy rugby players and to summarize neck strength values for this cohort, including rugby position-specific estimates. MATERIALS AND METHODS 52 male schoolboy rugby union players completed the neck strength test protocol twice, eight days apart using a novel device. RESULTS Intra-class correlation coefficients (ICCs) were good to excellent for test-retest reliability (range from 0.86 to 0.92) in all four directions. Intra-rater (ICCs range from 0.706 to 0.981) and inter-rater (ICCs range from 0.669 to 0.982) ranges were calculated. Significant differences were identified between forwards and backs for non-normalised force measures but no significant difference when normalised to bodyweight. The flexor:extensor ratio was 0.68 (SD 0.2) for forwards, 0.71 (SD 0.16) for backs and 0.67 (SD 0.16) for the cohort. DISCUSSION & CONCLUSION While there is limited direct evidence to support a direct link between neck strength and SRC risk at present, investigating the relationship of neck strength, stiffness and impact anticipation might be a useful direction for further research. In conclusion, we describe a portable, user-friendly and safe neck strength test with good-to-excellent test-retest reliability, and intra-, inter-rater reliability. Test-retest ICC values compare favourably to gold standard fixed-frame dynamometry and are superior to hand-held dynamometry.
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Affiliation(s)
- Colm Fuller
- Sports Medicine Research Department, Sports Surgery Clinic, Dublin, Ireland; College of Medicine and Health, University College Cork, Cork, Ireland.
| | - Éanna Falvey
- Sports Medicine Research Department, Sports Surgery Clinic, Dublin, Ireland; College of Medicine and Health, University College Cork, Cork, Ireland; World Rugby, World Rugby House 8-10 Lower Pembroke Street, Dublin 2, Ireland
| | - Kathryn Schneider
- Sport Injury Prevention Research Centre and Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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Grondin F, Colman D, Peyrot N, Maillard O, Freppel S, Caderby T, Perdrix Y. Reliability and difference in neck extensor muscles strength measured by a portable dynamometer in individuals with and without chronic neck pain. J Man Manip Ther 2022; 30:192-198. [PMID: 35332857 PMCID: PMC9255202 DOI: 10.1080/10669817.2021.2024676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE There are limited reports about the reliability of measuring neck extensor muscle strength using a portable dynamometer in neck pain patients. The aims of the current study were 1) to investigate intra- and inter-rater reliability of neck extensor isometric strength measurement using a portable dynamometer in patients with chronic nonspecific neck pain (CNSNP) and 2) to compare neck extensor isometric strength in participants with and without CNSNP. METHODS Guidelines for Reporting Reliability and Agreement Studies (GRRAS) were followed. Two examiners received a 15-minute training before enrollment. Inter-rater reliability was assessed with a 10-minute interval between measurements, and intra-rater reliability was assessed with a 10-day interval. Three trials were assessed and examiners were blind to the strength values (in Newtons) from other sessions of 20 individuals with CNSNP (mean±SD= 37.9 ± 9.8y; Neck Disability Index 29.2 ± 7.4%) and 20 individuals with other musculoskeletal disorders (mean ± SD = 32.8 ± 46.2y). RESULTS Intra-rater reliability was excellent with intraclass correlation coefficient (ICC)(3,1) of 0.95 (CI:0.90-0.97) and inter-rater reliability was good to excellent with ICC(2,1) of 0.88 (CI:0.77-0.94) in CNSNP. No significant difference of neck extensor strength was found between CNSNP (93.27N±31.94) and Individuals without CNSNP (111.43N±40.11) (p > 0.05). CONCLUSION A portable dynamometer is a reliable tool for measuring maximal isometric neck extension strength in individuals with CNSNP. Slightly but no significant differences of neck extensor strength values between individuals with and without CNSNP. Future studies are needed to assess the generalizability of the findings in patients with other muscle deconditioning.
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Affiliation(s)
- Francis Grondin
- Laboratoire IRISSE, UFR Des Sciences de l’Homme Et de l’Environnement, Université de La Réunion, La Réunion, France
- School of Physiotherapy (IFMK de la Réunion), Centre Hospitalier Universitaire de La Réunion, Reunion, France
- CONTACT Francis Grondin Laboratoire IRISSE, UFR Des Sciences de l’Homme Et de l’Environnement, Université de La Réunion, La Réunion, France
| | - David Colman
- Department of Physical Medicine and Rehabilitation, Liége University Hospital Center, Liége, Belgium
- Department of Sport and Rehabilitation Sciences, University of Liége, Liége, Belgium
| | - Nicolas Peyrot
- Laboratoire IRISSE, UFR Des Sciences de l’Homme Et de l’Environnement, Université de La Réunion, La Réunion, France
- Le Mans Université, Mouvement - Interactions - Performance, MIP, EA 43 34, F-72000 Le Mans, France
| | - Olivier Maillard
- Centre for Clinical Investigation (CIC 1410) Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion
| | - Sébastien Freppel
- Neurosurgery Department, Centre Hospitalier Universitaire de La Réunion, Reunion, France
| | - Teddy Caderby
- Laboratoire IRISSE, UFR Des Sciences de l’Homme Et de l’Environnement, Université de La Réunion, La Réunion, France
| | - Yannick Perdrix
- School of Physiotherapy (IFMK de la Réunion), Centre Hospitalier Universitaire de La Réunion, Reunion, France
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Anwar S, Arsalan SA, Zafar H, Ahmed A, Gillani SA, Hanif A. Effects of breathing re-education on endurance, strength of deep neck flexors and pulmonary function in patients with chronic neck pain: A randomised controlled trial. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2022; 78:1611. [PMID: 35547963 PMCID: PMC9082229 DOI: 10.4102/sajp.v78i1.1611] [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: 07/23/2021] [Accepted: 02/15/2022] [Indexed: 11/19/2022] Open
Abstract
Background People with chronic neck pain show decreased endurance and strength of cervical muscles with compromised respiratory function. There is little evidence that improvement in breathing function of people with neck pain can help in enhancing cervical muscle strength and pulmonary function. The objective of this our clinical trial was to examine the effects of breathing re-education combined with physiotherapy on endurance and strength of deep neck flexors, and pulmonary function in patients with chronic neck pain. Methods/design In this double blind randomised clinical trial, 30 patients with chronic neck pain (25-50 years old) were randomly allocated to two groups. Group A, physiotherapy (n = 15), and Group B, breathing re-education (n = 15). The duration of intervention was eight weeks with treatment five days a week. The endurance was measured with the craniocervical flexion test, strength with a handheld dynamometer (Baseline USA) and pulmonary functions with the Spiro lab 4 (USA) at baseline, at week four and at week eight of the intervention. Discussion There was a significant between group improvement in the strength of deep neck flexors and forced vital capacity (FVC) in Group B p = 0.0001 and p = 0.0200 (p ˂ 0.05) respectively. Intergroup comparisons showed no significant differences for endurance, cervical extensor strength, Forced Expiratory Volume in one second (FEV1), and FEV1/FVC percentage. Conclusion Our study concluded that breathing re-education combined with other physiotherapy management is effective for improving the strength of neck flexors and increasing FVC in people with chronic neck pain. Clinical implication Breathing re-education may be part of physiotherapy management in patients with chronic neck pain. Trial Registration Iranian Registry of Clinical Trials, IRCT20200226046623N1, https://www.irct.ir/trial/46240.
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Affiliation(s)
- Sahreen Anwar
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
| | - Syed A Arsalan
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
| | - Hamayun Zafar
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ashfaq Ahmed
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
| | - Syed A Gillani
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
| | - Asif Hanif
- Department of Biostatistics, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
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Romero-Franco N, Jiménez-Reyes P, Fernández-Domínguez JC. Concurrent Validity and Reliability of a Low-Cost Dynamometer to Assess Maximal Isometric Strength in Neck Movements. J Manipulative Physiol Ther 2021; 44:229-235. [PMID: 33461749 DOI: 10.1016/j.jmpt.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 02/18/2020] [Accepted: 08/03/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to evaluate the concurrent validity and reliability of a low-cost digital dynamometer to assess maximal isometric strength in neck movements. METHODS Twelve recreationally active participants (6 women, 6 men; age: 24.1 ± 3.4 years; height: 1.71 ± 0.06 m; weight: 64.6 ± 11.7 kg) performed neck flexion, extension, and lateral flexion, and maximal isometric strength was simultaneously measured using an isokinetic dynamometer (gold standard) and a digital dynamometer to evaluate the concurrent validity of the latter. One week later, all the participants repeated 3 trials of each neck movement (3 minutes apart) registered only with the digital dynamometer. The first and second trial were guided by tester 1 and the third trial was guided by tester 2. RESULTS The concurrent validity of the digital dynamometer showed a nearly perfect correlation between both devices (r > 0.986, P < .001), with Bland-Altman plots showing absolute agreement. Intertester and intratester reliability were nearly perfect for all neck movements (intraclass correlation coefficient > 0.86). CONCLUSION The low-cost digital dynamometer showed valid and reliable measurements of maximal isometric strength in neck movements.
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Affiliation(s)
- Natalia Romero-Franco
- Nursing and Physiotherapy Department, University of the Balearic Islands, Palma de Mallorca, Spain..
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Selistre LFA, Melo CDS, Noronha MAD. Reliability and Validity of Clinical Tests for Measuring Strength or Endurance of Cervical Muscles: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2020; 102:1210-1227. [PMID: 33383030 DOI: 10.1016/j.apmr.2020.11.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To evaluate the reliability and validity of clinical tests for measuring cervical muscle strength or endurance in participants with and without neck pain. DATA SOURCE Systematic review and meta-analysis on reliability and validity. Literature search was conducted on January 28, 2020, using 5 databases: MEDLINE, Cumulative Index to Nursing and Allied Health, EMBASE, SPORTDiscus, and Scopus. STUDY SELECTION We included studies that investigated the reliability or validity of clinical tests for measuring cervical muscle strength or endurance in participants with nonspecific chronic neck pain, with or without irradiation, or healthy participants. We included only those that were viable for daily practice and of low cost. DATA EXTRACTION Data were extracted as follows: (1) author and year of publication, (2) demographic values and health condition, (3) reported clinical tests, (4) inclusion and exclusion criteria, (5) description of test, (6) interrater reliability, and (7) intrarater reliability. For validity studies we also extracted the (8) reference method and (9) validity estimates. DATA SYNTHESIS Methodological quality was assessed with the Quality Appraisal of Diagnostic Reliability and the Guidelines for Reporting Reliability and Agreement Studies. Data on reliability and validity were extracted from included articles and then analyzed. RESULTS Thirty-one studies were included. Cervical flexor and extensor endurance test, craniocervical flexion test (CCFT), AND cervical muscle strength using a handheld dynamometer (HHD) showed moderate to good intra- and interrater reliability (intraclass correlation coefficients ranging from 0.64-0.90). Concurrent validity was measured by only 2 studies, which do not provide adequate evidence for a recommendation. CONCLUSIONS The cervical flexor and extensor endurance tests, CCFT, and HHD for measuring cervical strength presented an acceptable interrater and intrarater reliability.
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Affiliation(s)
| | - Cristiane de Sousa Melo
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
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Tudini FT, Myers BJ, Bohannon RW. Forward flexed posture: reliability and determinants of tragus-to-wall measurement. Physiother Theory Pract 2020; 38:579-586. [PMID: 32466740 DOI: 10.1080/09593985.2020.1771801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Forward flexed posture is an impairment in body structure commonly seen among older adults and those with pathologies such as ankylosing spondylitis and osteoporosis. Accurate measurement of forward flexed posture is important as it is related to pain, mobility limitations, and falls. Our purpose was to examine the reliability and determinants of forward flexed posture as indicated by tragus-to-wall (TTW) distance. METHODS Twenty healthy younger and 20 healthy older adults were included in this secondary analysis of data from a neck strength study. Measurements included the linear distance of TTW standing naturally and with neck retraction, age, gender, body mass index (BMI), and neck retraction strength. Measurements were performed initially by 2 investigators and by the primary investigator 1 week later. Intraclass correlation coefficients (ICCs) (model 3,1) described relative reliability and Bland-Altman plots characterized absolute reliability. A mixed general linear model examined the determinants for TTW distance. RESULTS Good inter-rater (ICC = 0.811-0.878) and test-retest reliability (ICC = 0.853-0.862) were found in both positions. Bland-Altman plots showed that absolute limits of agreement ranged from - 1.9 to +3.8 cm for inter-rater reliability and -2.4 to +2.6 cm for test-retest reliability. Analysis of TTW determinants demonstrated significant differences between neck positions, dichotomous age groups, and BMI groups (p ≤ 0.001). There was no significant difference based on neck strength. CONCLUSIONS Our results indicate that TTW distance, measured using a standardized procedure, is a reliable method of quantifying forward flexed posture. TTW distance is greater in relaxed standing, older individuals, and those with greater BMI.
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Affiliation(s)
- Frank T Tudini
- Physical Therapy, Campbell University College of Pharmacy and Health Sciences, Buies Creek, NC, USA
| | - Bradley J Myers
- Physical Therapy, Campbell University College of Pharmacy and Health Sciences, Buies Creek, NC, USA
| | - Richard W Bohannon
- Physical Therapy, Campbell University College of Pharmacy and Health Sciences, Buies Creek, NC, USA
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Tudini F, Myers B, Bohannon R. Reliability and validity of measurements of cervical retraction strength obtained with a hand-held dynamometer. J Man Manip Ther 2019; 27:222-228. [PMID: 30935321 DOI: 10.1080/10669817.2019.1586167] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Objectives: The purpose of this study was to describe the reliability and validity of measurements of cervical retraction strength obtained with a hand held dynamometer (HHD) from healthy adults. Background: Impaired neck muscle strength is related to neck pain, abnormal posture, and various cervical pathologies. While sophisticated devices to objectively measure neck strength exist, many are not practicable in typical orthopedic practices or have questionable validity and reliability. Methods: Forty participants were included in the analysis of neck strength using isometric testing with an HHD fixed in a cradle on a table top. The highest neck retraction force recorded in Newtons (N) for each participant, was used for data analysis. Results: Both intratester and intertester reliability were excellent as judged by intraclass correlation coefficients (ICCs) (.885 - .974) and minimal detectable change (MDC) (21.1 to 47.6 N). Validity was confirmed on the basis of expected gender and age differences (ie, men were stronger than women and younger participants were stronger than older participants). Conclusion: Fixed HHD is a reliable and valid tool for measuring isometric neck retraction strength in ostensibly healthy adults. Its value in the assessment of individuals with neck pathology awaits further examination.
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Affiliation(s)
- Frank Tudini
- a College of Pharmacy and Health Sciences, Doctor of Physical Therapy Program, Campbell University , Buies Creek , NC , USA
| | - Bradley Myers
- a College of Pharmacy and Health Sciences, Doctor of Physical Therapy Program, Campbell University , Buies Creek , NC , USA
| | - Richard Bohannon
- a College of Pharmacy and Health Sciences, Doctor of Physical Therapy Program, Campbell University , Buies Creek , NC , USA
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