title: To What Degree Does Active Cervical Range of Motion Differ Between Patients With Neck Pain, Patients With Whiplash, and Those Without Neck Pain? A Systematic Review and Meta-Analysis.
abstract: To quantify differences in active cervical range of motion (aCROM) between patients with neck pain and those without neck pain, in patients with whiplash-associated disorders (WADs) and nontraumatic neck pain, and in patients with acute complaints versus those with chronic complaints.
  
  
  
  Seven bibliographic databases were searched from inception to April 2015. In addition, a manual search was performed.
  
  
  
  Full articles on a numerical comparison of aCROM in patients with neck pain and asymptomatic control persons of similar ages were included. Two reviewers independently selected studies and assessed risk of bias.
  
  
  
  Two reviewers extracted the data. Pooled mean differences of aCROM were calculated using a random-effects model.
  
  
  
  The search yielded 6261 hits; 27 articles (2366 participants, 13 low risk of bias) met the inclusion criteria. The neck pain group showed less aCROM in all movement directions compared with persons without neck pain. Mean differences ranged from -7.04° (95% CI, -9.70° to -4.38°) for right lateral bending (11 studies) to -89.59° (95% CI, -131.67° to -47.51°) for total aCROM (4 studies). Patients with WADs had less aCROM than patients with nontraumatic neck pain. No conclusive differences in aCROM were found between patients with acute and patients with chronic complaints.
  
  
  
  Patients with neck pain have a significantly decreased aCROM compared with persons without neck pain, and patients with WADs have less aCROM than those with nontraumatic neck pain.
authors.affiliation: Department of Manual Therapy, SOMT, Institute for Master Education in Musculoskeletal Therapies, Amersfoort, The Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands. Electronic address: m.stenneberg@somt.nl.
authors.forename: Martijn S
authors.initials: MS
authors.lastname: Stenneberg
authors.affiliation: Department of Manual Therapy, SOMT, Institute for Master Education in Musculoskeletal Therapies, Amersfoort, The Netherlands; Department of Experimental Anatomy, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Michiel
authors.initials: M
authors.lastname: Rood
authors.affiliation: Department of Manual Therapy, SOMT, Institute for Master Education in Musculoskeletal Therapies, Amersfoort, The Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands; Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: de Bie
authors.affiliation: Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.
authors.forename: Maarten A
authors.initials: MA
authors.lastname: Schmitt
authors.affiliation: Department of Experimental Anatomy, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Erik
authors.initials: E
authors.lastname: Cattrysse
authors.affiliation: Department of Manual Therapy, SOMT, Institute for Master Education in Musculoskeletal Therapies, Amersfoort, The Netherlands; Vrije Universiteit Amsterdam, Faculty of Behavioural and Movement Sciences, Department of Human Movement Sciences, MOVE Research Institute, Amsterdam, The Netherlands.
authors.forename: Gwendolijne G
authors.initials: GG
authors.lastname: Scholten-Peeters
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002574:Cervical Vertebrae / Q000503:physiopathology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D019547:Neck Pain / Q000503:physiopathology*; D016059:Range of Motion, Articular / Q000502:physiology*; D014911:Whiplash Injuries / Q000503:physiopathology*; D055815:Young Adult
keywords: Neck pain; Range of motion, articular; Rehabilitation; Review; Whiplash injuries