title: Kinematic evaluation of 4 pediatric collars and distribution of cervical movement between primary and coupled angles.
abstract: BACKGROUND
  Primary and coupled angle restrictions, when neck collars are used, have been investigated mainly in adults and not yet in children.
  
  
  OBJECTIVE
  To evaluate the efficiency of 4 pediatric collars in reducing cervical range of motion (ROM) in primary and coupled planes.
  
  
  METHODS
  Thirty asymptomatic children (16 boys and 14 girls) aged 6 to 12 years participated in the study. A motion analysis system was used to evaluate the ROM of the cervical spine during flexion/extension, left and right lateral bending, and left and right axial rotation. Primary and coupled ROM were evaluated in unbraced and braced conditions. Four cervical collars were tested: Philadelphia, Miami Jr, Necloc, and the conventional Hard Collar. Thirteen subjects were tested 2 times to evaluate the repeatability of the parameters. The ROM in each plane was normalized to the sum of the ROM in the 3 planes, for each movement, to estimate the percentage of the movement in each plane (normalized ROM), in braced and unbraced conditions. The analysis of variance and post hoc Benferroni tests were applied on raw and normalized ROM.
  
  
  RESULTS
  ROM collected in collars showed a significant difference compared with the unbraced condition. ROM obtained in Necloc and Miami Jr showed a significant difference compared with Philadelphia and conventional Hard Collar. The primary plane is activated at 80% during flexion-extension and left-right axial rotation; however, 55% of the total movement was completed in the frontal plane during left-right lateral bending in unbraced condition. Statistical differences in the normalized ROM were found between the braced and unbraced conditions and among collars.
  
  
  CONCLUSIONS
  Necloc and Miami Jr presented the highest limitation of movement in the primary and secondary planes. The distribution strategy of a movement, between primary and coupled angles, is different between the braced and unbraced conditions.
authors: *Laboratory of Biomechanics, School of Medicine, PTS Campus of Innovation and Sport †Gait and Motion Analysis Laboratory, SESOBEL §Hôtel Dieu de France Hospital, Beirut, Lebanon ‡Laboratoire de Biomécanique, Arts et Métiers ParisTech, Paris, France.
authors: Ayman
authors: A
authors: Assi
authors: Paul
authors: P
authors: Yazbeck
authors: Abir
authors: A
authors: Massaad
authors: Wafa
authors: W
authors: Skalli
authors: Ismat
authors: I
authors: Ghanem
mesh_terms: D001696:Biomechanical Phenomena; D001915:Braces; D002574:Cervical Vertebrae / Q000502:physiology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009333:Neck / Q000502:physiology; D016059:Range of Motion, Articular; D012399:Rotation; D013165:Splints