Victoria Andersen1, Xu Wang2, Mark de Zee3, Lasse Riis Østergaard4, Maciej Plocharski4, René Lindstroem4. 1. Department of Health Science and Technology, Aalborg University, 9220, Aalborg, Denmark. veba@hst.aau.dk. 2. The Second Hospital of Jilin University, Jilin University, Qianjin St. 2699, Changchun, 130021, China. x.wang2013@hotmail.com. 3. Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, 9220, Aalborg, Denmark. 4. Department of Health Science and Technology, Aalborg University, 9220, Aalborg, Denmark.
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. STUDY DESIGN: This is an observational study. SUBJECT SAMPLE: Thirty-three healthy subjects participated in the study. OUTCOME MEASURES: 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.
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. STUDY DESIGN: This is an observational study. SUBJECT SAMPLE: Thirty-three healthy subjects participated in the study. OUTCOME MEASURES: 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.
Entities:
Keywords:
Cervical vertebrae; Fluoroscopy; Maximum motion; Neck; Range of motion
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