title: Cervical spine ROM measurements: optimizing the testing protocol by using a 3D ultrasound-based motion analysis system.
abstract: The aim of this study was to evaluate the intra- and inter-examiner reliability and validity of neck range of motion (ROM) measurements. Thirty-five healthy subjects were assessed in all neck movements from two initial positions, sitting and standing, actively (open and closed eyes) and passively by using a 3D ultrasound-based motion analysis device (Zebris). Three tests were employed to assess intra-examiner reliability and two examiners used for the inter-examiner reliability. X-rays in neck flexion and extension were used to validate the Zebris system. The standing position yielded higher intraclass correlation coefficient (ICC) values (>0.86) with less error [smallest detectable difference (SDD)<13.8%] than sitting (ICC>0.79, SDD<14%). Passive assessment of neck ROM presented better reproducibility than active assessment with open or closed eyes in both positions. The inter-examiner reliability was moderate (ICC=0.43-0.68). The correlation between the Zebris system and X-rays was high in both flexion and extension movements. The results showed that the most reliable protocol for assessment of neck ROM is a passive measurement in the standing position. The measurements were well validiated against X-rays and the experience of the investigators must be considered before any comparison among studies is employed.
authors.affiliation: Centre for Rehabilitation Science, University of Manchester, Manchester, UK, and Department of Radiology, Evgenidion Hospital, Athens, Greece. nikstrimp@teilam.gr
authors.forename: N
authors.initials: N
authors.lastname: Strimpakos
authors.forename: V
authors.initials: V
authors.lastname: Sakellari
authors.forename: G
authors.initials: G
authors.lastname: Gioftsos
authors.forename: M
authors.initials: M
authors.lastname: Papathanasiou
authors.forename: E
authors.initials: E
authors.lastname: Brountzos
authors.forename: D
authors.initials: D
authors.lastname: Kelekis
authors.forename: E
authors.initials: E
authors.lastname: Kapreli
authors.forename: J
authors.initials: J
authors.lastname: Oldham
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000502:physiology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D015588:Observer Variation; D010808:Physical Examination / Q000379:methods*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography