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Kinematic analysis of 3-dimensional mobilization techniques of the upper cervical spine: a reliability analysis and comparison of techniques
Tijdschriftbijdrage - Tijdschriftartikel
Aim. No previous studies analyzed the three-dimensional kinematic aspects of the upper cervical spine during manual combined mobilizations. The present in-vitro study aims to analyze the kinematic behavior of the atlanto-occipital joint during 3D mobilizations and the undesired movements of C1-C2. The comparison between locking and manual fixation techniques is reported, also considering a kinematic analysis of the performed motions. An intra and inter-reliability analysis is also studied.
Methods. Twenty fresh human cervical specimens were studied in a test-retest situation with two examiners, using a Zebris CMS20 ultrasound-based tracking system. Two different 3D- mobilizations (flexion-right axial rotation and flexion-left axial rotation) of the atlanto-occipital joint were performed, comparing segmental manual fixation and segmental locking techniques of C1-C2 segment. The intra- and inter-examiners reliability and kinematics were analyzed.
Results. Although no significant differences between examiners were found, the results do not demonstrate a significant correlation. The manual fixation technique and the direction of axial rotation to the right enables to increase the flexion motion in the atlanto-occipital joint. The manual fixation nor the locking technique influences the axial rotation motion in the atlanto-occipital joint. The cross-correlation parameter demonstrated a contra-lateral pattern between main axial rotation and coupled lateral bending in the atlanto-occipital joint, but an ispi-lateral pattern in the atlanto-axial joint. The main axial rotation was greater than the coupled lateral bending, mainly in the C1-C2 segment.
Conclusion. The use of different segmental manual techniques during complex mobilizations can influence the kinematics of the upper-cervical spine. However, as a reproducibility is low, 3D-kinematic variability is high.
Methods. Twenty fresh human cervical specimens were studied in a test-retest situation with two examiners, using a Zebris CMS20 ultrasound-based tracking system. Two different 3D- mobilizations (flexion-right axial rotation and flexion-left axial rotation) of the atlanto-occipital joint were performed, comparing segmental manual fixation and segmental locking techniques of C1-C2 segment. The intra- and inter-examiners reliability and kinematics were analyzed.
Results. Although no significant differences between examiners were found, the results do not demonstrate a significant correlation. The manual fixation technique and the direction of axial rotation to the right enables to increase the flexion motion in the atlanto-occipital joint. The manual fixation nor the locking technique influences the axial rotation motion in the atlanto-occipital joint. The cross-correlation parameter demonstrated a contra-lateral pattern between main axial rotation and coupled lateral bending in the atlanto-occipital joint, but an ispi-lateral pattern in the atlanto-axial joint. The main axial rotation was greater than the coupled lateral bending, mainly in the C1-C2 segment.
Conclusion. The use of different segmental manual techniques during complex mobilizations can influence the kinematics of the upper-cervical spine. However, as a reproducibility is low, 3D-kinematic variability is high.
Tijdschrift: Italian Journal of Physiotherapy
ISSN: 2240-4929
Issue: 2
Volume: 3
Pagina's: 38-46
Jaar van publicatie:2013