Related Experiment Video
Updated: Jul 19, 2026
10:53
A Novel Application of Musculoskeletal Ultrasound Imaging
Published on: September 17, 2013
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
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.
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.
