Monday, May 05, 2008

Range of motion measures in non specific neck pain

May 1, 2008 on 11:02 am | In Neck Pain |

Clinimetric evaluation of active range of motion measures in patients with non-specific neck pain

From: European Spine Journal 2008 Apr 22 [Epub ahead of print]

Neck pain is a common musculoskeletal disorder. The incidence of neck pain in the Netherlands has been estimated as 23.1 per 1,000 person years. In general, women have more neck pain than men. In the Netherlands, 51% of patients with acute non-specific neck pain who consulted their general practitioners were referred to physiotherapists for treatment.

Neck pain may result from many causes (trauma, infections or inflammatory conditions, rheumatic disorders and congenital diseases), but most often no specific cause can be found and the condition is labelled as non-specific neck pain. In their clinical examination, physiotherapists and other healthcare providers may routinely perform an assessment of the active cervical range of motion (active neck range of motion ) to assess the level of impairment associated with neck pain as well as the results of treatment. Typical active neck range of motion assessments of the cervical spine include flexion and extension in the sagittal plane, lateral flexion in the frontal plane and rotation in the transverse plane. Tests or instruments which are used to examine active neck range of motion in patients with non-specific neck pain should meet several clinimetric prerequisites, such as an acceptable level of reproducibility, validity and responsiveness.

Recently, several systematic reviews have been published on the assessment of passive cervical range of motion and palpation procedures of the cervical spine. Among the palpation procedures, pain provocation tests were found to be the most reliable and the assessment of regional passive cervical range of motion instrument was found to be more reliable than segmental passive cervical range of motion instrument. However, in these reviews it was also concluded that most studies were of a poor methodological quality.

In 2000, a review was published that assessed the reliability of tools used to measure active neck range of motion . This review concluded that the cervical range of motion device has shown promising reliability. Our overview takes account not only of reliability, but also of validity and responsiveness.

The objective of the present systematic review, therefore, is to provide an overview of the current knowledge on clinimetric properties of instruments that are practical to use when evaluating active neck range of motion in patients with non-specific neck pain.

The present review provides information for researchers and clinicians to facilitate choice amongst existing instruments for measuring active neck range of motion . A systematic computerized literature search of databases revealed three different types of instruments that are practical to use when measuring active neck range of motion in patients with non-specific neck pain: visual estimation, tape measurements, different types of goniometers/inclinometers. When a healthcare professional decides that measuring active neck range of motion on a patient with non-specific neck pain is necessary, a single inclinometer and cervical range of motion instrument are to be recommended based on their best ratings for clinimetric properties and practicality. Visual estimation should not be used to measure active neck range of motion.

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