Comparison of Cervical Spine Motion During Application Among 4 Rigid Immobilization Collars

OBJECTIVE: To quantify the cervical spine range of motion that occurred during application of 4 rigid cervical immobilization collars, the time of application, and the amount of active range of motion available after application. DESIGN AND SETTING: We evaluated the amount of cervical motion that occurred during application of 4 commonly used collars: NECLOC (NL), StifNeck (SN), StifNeck Select (SNS), and Rapid Form Vacuum Immobilizer (VI). Each clinician applied a properly sized collar to both a small- and medium-size model 3 times. After application, active range-of-motion testing was completed with the subject in the supine and seated positions. SUBJECTS: A total of 17 certified athletic trainers participated. MEASUREMENTS: We used 3-dimensional kinematic head and thorax data to calculate peak angular displacement, total linear distance, and total angular distance during application and peak angular displacement during supine and seated range-of-motion testing. Application time was calculated during each trial. RESULTS: Significant differences between collars were noted for application time, total linear distance, and total angular distance (P<.01). The SN and SNS were applied significantly faster and with significantly less total linear distance and total angular distance than the NL and the VI collars. The NL was applied significantly faster and with significantly less total linear distance and total angular distance than the VI. During supine and seated active range-of-motion tests, the SN and SNS permitted significantly less cervical flexion-extension, rotation, and lateral flexion than the NL and VI. CONCLUSIONS: Of the collars tested, the SN and SNS appear to be the optimal collars for use by certified athletic trainers. They were applied with the least motion in the fastest time and provided superior restriction during active range-of-motion testing.