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Subjective and Objective Assessment of the Preferred Rotational Cervical Spine Position in Infants with an Upper
Anke Langenfeld1, Inga Paravicini1, Mette Hobaek Siegenthaler1
1Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland.
Insights
Parental awareness of infant cervical rotation preference aligns well with clinician assessments, offering a reliable basis for examination. Objective measurements using inertial measurement units (IMUs) showed poor to moderate test-retest reliability in infants.
Area of Science:
- Pediatric healthcare
- Infant musculoskeletal health
- Clinical assessment methods
Background:
- Assessing infant cervical rotation preference is crucial for early detection of musculoskeletal issues.
- Understanding parental awareness and agreement with clinical and objective findings is important for comprehensive care.
Purpose of the Study:
- To evaluate parental awareness of infant cervical rotation preference.
- To determine the agreement between parent, clinician, and objective assessments of infant cervical rotation.
- To assess the test-retest reliability of objective measurements of infant cervical range of motion.
Main Methods:
- A cross-sectional study involving 69 infants (3-6 months) with upper cervical spine dysfunction.
- Parent and clinician assessments of cervical rotation preference were recorded.
- Cervical range of motion was measured using inertial measurement units (IMUs) at two time points.
Main Results:
- Strong correlation found between parent and clinician assessments (rs = 0.687, p < 0.001).
- Moderate correlations were observed between clinician and IMU (rs = 0.408, p = 0.005), and parent and IMU (rs = 0.301, p = 0.044) assessments.
- Test-retest reliability for IMU measurements of cervical range of motion ranged from poor to moderate.
Conclusions:
- Parental assessment of infant cervical rotation preference can serve as a valuable foundation for clinical examinations.
- Objective IMU measurements in infants may be challenging due to cooperation issues, impacting reliability.
Background:
We aimed to assess (1) the awareness of parents regarding the cervical rotation preference of their infant and the agreement of the parent, clinician and objective assessments, and (2) the test-retest reliability for objective (measured) rotation, lateral flexion and combined flexion-rotation.
Methods:
This was a cross-sectional study including 69 infants aged three to six months with upper cervical spine dysfunction, without general health issues or specific cervical spine impairments. No treatment was applied. The primary outcomes were parent and clinician assessments of cervical spine rotation preference. The secondary outcome was the cervical range of motion measured by inertial measurement units (IMUs) at two different timepoints. Spearman correlation was performed for the parent, clinician and objective assessments. IMU data were dichotomized into the preferred and unpreferred sides, and test-retest reliability was assessed (ICC).
Results:
The mean age of infants was 145 days ± 29.1 days, birth length 49.40 cm ± 2.7 cm, birth weight 3328 g ± 530.9 g and 24 were female. In total, 33 infants were assessed by their parents as right-preferred, 30 as left-preferred and 6 as having no preference. The clinician assessed 38 infants as right-preferred and 31 as left-preferred. The correlation between parents and the clinician was rs = 0.687 (p < 0.001), the clinician and the IMU rs = 0.408 (p = 0.005) and parents and the IMU rs = 0.301 (p = 0.044). The ICC of cervical range of motion measurements ranged from poor to moderate.
Conclusions:
Clinicians can use the parents' assessment of cervical spine rotation preference as a foundation for their clinical examination. IMU measurements are difficult in infants, possibly due to their lack of cooperation during measurements.
Clinical Trial Registration Number:
clinicaltrails.gov (NCT04981782).
