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A Novel Application of Musculoskeletal Ultrasound Imaging
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Cervical spine ROM measurements: optimizing the testing protocol by using a 3D ultrasound-based motion analysis

N Strimpakos1, V Sakellari, G Gioftsos

  • 1Centre for Rehabilitation Science, University of Manchester, Manchester, UK, and Department of Radiology, Evgenidion Hospital, Athens, Greece. nikstrimp@teilam.gr

Cephalalgia : an International Journal of Headache
|November 25, 2005
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Summary

This study found that passive neck range of motion (ROM) measurements in a standing position are most reliable. The 3D ultrasound Zebris system showed high validity compared to X-rays.

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Area of Science:

  • Biomechanics
  • Rehabilitation Medicine
  • Medical Imaging

Background:

  • Accurate measurement of neck range of motion (ROM) is crucial for diagnosing and managing various musculoskeletal conditions.
  • Previous methods for assessing neck ROM have limitations in reliability and validity.
  • Standardization of measurement protocols is needed for consistent clinical and research applications.

Purpose of the Study:

  • To evaluate the intra- and inter-examiner reliability and validity of neck ROM measurements using a 3D ultrasound-based motion analysis device (Zebris).
  • To compare the reliability of measurements taken in sitting versus standing positions.
  • To determine the most reliable protocol for assessing active and passive neck ROM.

Main Methods:

  • Thirty-five healthy subjects participated in the study.
  • Neck ROM was measured in sitting and standing positions, actively (eyes open/closed) and passively, using the Zebris system.
  • Intra-examiner reliability was assessed using three tests, and inter-examiner reliability involved two examiners.
  • X-rays in neck flexion and extension were used for system validation.

Main Results:

  • The standing position demonstrated higher reliability (Intraclass Correlation Coefficient [ICC] >0.86) and lower error (Smallest Detectable Difference [SDD] <13.8%) compared to the sitting position (ICC >0.79, SDD <14%).
  • Passive neck ROM assessment showed better reproducibility than active assessment in both positions.
  • Inter-examiner reliability was moderate (ICC=0.43-0.68).
  • The Zebris system demonstrated high correlation with X-ray measurements for flexion and extension.

Conclusions:

  • Passive neck ROM measurement in the standing position using the Zebris system is the most reliable protocol.
  • The Zebris system is well-validated against X-rays for assessing neck ROM.
  • Investigator experience should be considered when comparing results across studies.