Relating a manual medicine diagnostic test of cervical motion function to specific three-dimensional kinematic variables

Bush, Tamara Reid; Vorro, Joseph; Alderink, Gordon; Gorbis, Sherman; Li, Mingfei; Leitkam, Samuel

doi:10.1016/j.ijosm.2010.01.005

« Previous Next »International Journal of Osteopathic Medicine
Volume 13, Issue 2 , Pages 48-55, June 2010

Relating a manual medicine diagnostic test of cervical motion function to specific three-dimensional kinematic variables

Tamara Reid Bush
- Department of Mechanical Engineering, College of Engineering, Michigan State University, East Lansing, MI 48824, United States
- Corresponding author. Tel.: +1 517 353 9544.
Joseph Vorro
- Department of Family Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, United States
Gordon Alderink
- Department of Physical Therapy, College of Health Professions, Grand Valley State University, Grand Rapids, MI 49503, United States
Sherman Gorbis
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, United States
Mingfei Li
- Department of Mathematical Sciences, Bentley University, Waltham, MA 02452, United States
Samuel Leitkam
- Department of Mechanical Engineering, College of Engineering, Michigan State University, East Lansing, MI 48824, United States

Received 12 December 2008; received in revised form 8 June 2009; accepted 27 January 2010. published online 22 April 2010.

Abstract

Background

The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and its Associated Disorders (BJD) indicates that there is a significant shortage of scientific research to support manual therapies in diagnosis and treatment, specifically for the cervical region.

Objective

The purpose of this research was to quantify motions associated with the palpatory diagnostic procedure of cervical lateral flexion using three-dimensional (3-D) motion capture techniques. Further, these data were examined for relationships with the clinical diagnosis.

Design setting

3-D kinematic data were examined for relationships to a palpatory diagnostic test of cervical lateral flexion.

Methods

A five-camera video based motion system was used to collect 3-D data during passive cervical lateral flexion. These data were then used to compute head movements relative to the thorax. Statistical analysis of the angular data included non-parametric tests, binary logistical regression and cluster analysis.

Subjects

Eighty-five subjects were classified into two groups: asymptomatic (n = 76) with a VAS < 4, and symptomatic (reporting neck pain on the day of the experiment) with a VAS ≥ 4/10 (n = 9). Only asymptomatic subjects with symmetrical passive cervical lateral flexions as determined by the blinded consensus of two experienced and trained examiners were included in the study (n = 10).

Results

Symptomatic subjects exhibited significantly greater kinematic differences between repeat trials of the diagnostic test as compared to asymptomatic subjects. The data also suggests a trial dependent “warm up” effect. Further, the cluster analysis of the difference measure showed the potential of kinematic analysis to discern between the two subject groups.

Conclusions

Results from this study demonstrate the ability to generate objective data that can be related to a manual medicine diagnostic test. This methodological approach may serve as a foundation for additional kinematic studies of manual medicine techniques, as well supporting work for documenting treatment outcomes and to assisting in teaching and training clinicians.

Keywords: Biomechanics, Spinal mechanics, Cervical spine, Manual medicine, Kinematic, Palpatory, Evidence-based medicine, Diagnostic techniques