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Chiropractic Research Review

Questioning the Reliability of Cervical Spine ROM Tools

Range of motion (ROM) of different parts of the body is vital to assessing and diagnosing numerous musculoskeletal diseases. Typical movements measured in reliability studies relating to the neck include flexion and extension in the sagittal plane, lateral flexion to the left and right in the frontal plane, and rotation to the left and right in the transverse plane.

Measuring maximum range of motion (ROM) for these six movements can be accomplished using several commonly utilized devices, although the effectiveness of available measuring tools has been questioned.

This study reviewed the reliability of tools for measuring cervical spine ROM in clinical settings by analyzing published studies on the subject. A comprehensive database and citation search was used to select studies assessing inter or intraobserver reliability; evaluating movements of flexion/extension, lateral flexion or rotation; and measuring ROM of the entire cervical spine.

Twenty-one papers met the selection criteria for the study and were reviewed by a nonclinical researcher, a consultant rheumatologist and a physiotherapist. Date from published studies on the reliability of the cervical range-of-motion device (CROM); electrogoniometer; inclinometer (single and double); rangiometer; spine motion analyzer; and other forms of ROM measurement (visual estimation, tape measure, etc.) were insufficient to make a strong recommendation for using one tool over the other. Measurement tools were not fully tested for reliability, particularly in terms of sample size, appropriate analysis techniques, and several other variables.

The authors conclude that despite the promise range-of-motion devices have shown, their clinical reliability has yet to be established in the literature. They call for more rigorous studies on the reliability of all measurement tools.

Jordan K. Assessment of published reliability studies for cervical spine range-of-motion measurement tools. Journal of Manipulative and Physiological Therapeutics, March/April 2000:23(3), pp180-95. Reprints: Tel: (800) 325-4177 (ext. 4350); Fax: (314) 432-1380

Chiropractic Research Review

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