Kinematic measures during a clinical diagnostic technique for human neck disorder: inter- and intraexaminer comparisons

Joseph Vorro, Tamara R Bush, Brad Rutledge, Mingfei Li, Joseph Vorro, Tamara R Bush, Brad Rutledge, Mingfei Li

Abstract

Diagnoses of human musculoskeletal dysfunction of the cervical spine are indicated by palpable clues of a patient's structural compliance/noncompliance as this body segment responds to diagnostic motion demands applied by a clinician. This process includes assessments of motion range, motion performance, and changes in tissue responses. However, biomechanical quantification of these diagnostic actions and their reproducible components is lacking. As a result, this study sought to use objective kinematic measures to capture aspects of the diagnostic process to compare inter- and intraexaminer motion behaviors when performing a specific clinical diagnostic protocol. Pain-free volunteers and a group determined to be symptomatic based on a psychometric pain score were examined by two clinicians while three-dimensional kinematic data were collected. Intraexaminer diagnostic motion ranges of cervical lateral flexion and secondary rotations were consistent for each examiner and for each subject group. However, interexaminer comparisons for motion range, secondary rotations, and average velocities yielded consistently larger measures for one examiner for both subject groups (P < 0.05). This research demonstrates that fundamental aspects of the clinical diagnostic process for human neck disorders can be identified and measured using kinematic parameters. Further, these objective data have the potential to be linked to clinical decision making.

Trial registration: ClinicalTrials.gov NCT01186718.

Figures

Figure 1
Figure 1
(a) Examiner and subject positions, with motion capture cameras in place. (b) Retroreflective marker positions during execution of the lateral flexion diagnostic test.
Figure 2
Figure 2
Lateral flexion and coupled axial rotations of the head during the diagnostic test.
Figure 3
Figure 3
Angular velocities for diagnostic tests, subject group, trials and examiners. Data represent average velocities for each trial for all subjects. Bars represent one standard deviation.
Figure 4
Figure 4
Comparisons between Examiner 2 (dark blue) and Examiner 3 (grey) for average total passive diagnostic ROM. Bars represent one standard deviation.
Figure 5
Figure 5
Comparisons between Examiner 2 (dark blue) and Examiner 3 (grey) for average secondary rotations. Bars represent one standard deviation.

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Source: PubMed

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