Reproducibility of global three-dimensional motion during manual atlanto-axial rotation mobilization: anin vitrostudy

Abstract

The reproducibility of the three-dimensional (3D) kinematic aspects of motion coupling patterns during manual mobilizing techniques is still a debatable matter. The present in vitro study analysed segmental 3D motion of the atlanto-axial joint during manual axial rotation mobilization. Twenty fresh frozen human cervical specimens were studied in a test-retest situation with two examiners. The specimens were manually mobilized using three different techniques: (1) a regional mobilization technique of the cervical spine; (2) a segmental mobilization technique of the atlas with manual fixation of the axis; and (3) a segmental mobilization of the atlas on the axis applying a locking technique. Segmental atlanto-axial kinematics was registered with a Zebris CMS-20 ultrasound-based tracking system. The Euclidian norm was used as a representation of overall 3D motion. The results indicated good reproducibility (mean intraclass correlation coefficient, ICC: 0.87). Intraobserver reproducibility was slightly higher (mean ICC: 0.91; range: 0.76-0.99) than interobserver reproducibility (mean ICC: 0.85; range: 0.56-0.98) (P , 0.05). The total range of motion expressed as the Euclidean norm of 3D motion components was a parameter with good reproducibility in the study of segmental kinematics of manual atlanto-axial mobilization. Although previous studies have demonstrated poor inter-rater reliability of manual examination and mobilization of segmental motion components, the results of the present study shed a new and more positive light on the reproducibility of techniques for manual mobilization of the upper cervical spine.

Pain and Vertebral Dysfunction in Dry Immersion: A Model of Microgravity Simulation Different from Bed Rest Studies

“…Reproducibility of manual and more specifically segmental mobilization techniques remain a debatable matter in the literature. There seems to be a general tendency towards higher intraobserver reliability compared to interobserver results [ 45 – 48 ]. This is a new preventive approach of back pain, which has the advantage of being passive, noninvasive, and without any bias with other measurements.…”

Reproducibility of the Kinematics in Rotational High-Velocity, Low-Amplitude Thrust of the Upper Cervical Spine: A Cadaveric Study

“…29 Moreover, generally, reproducibility of manual segmental techniques seems to be characterized by a tendency towards higher intraexaminer reproducibility compared to interexaminer results. 19,22,[30][31][32][33][34][35][36][37][38] According to the previous literature, the present study involving segmental HVLA on C1-C2 shows a high intraexaminer reliability-almost perfect for one examiner and fair for the other one-and a substantial interexaminer reliability only in the main axial rotation component. This implies that, clinically, HVLA manipulations are preferably executed by the same therapist and they are reproducible only for their main component.…”

“…Maybe the reliability was not reached in all components because therapists use different motion components to achieve the manipulation. The most recent study of Cattrysse et al 19 show high interexaminer reproducibility analyzing the global 3D motion during manual axial rotation mobilization of C1-C2 expressed as the Euclidian norm. Maybe taking into account all 3D components, the reproducibility on HVLA manipulation could improve.…”

“…17,18 In the field of manual therapy, the reproducibility of the cervical spine techniques is a debated subject, creating a need for more specific research. [19][20][21] In vitro segmental reproducibility of kinematics in the upper cervical spine has never been examined during high-velocity thrust (HVLA) techniques. However, up to the present, an in vitro approach is the only possible way to analyze segmental joint kinematics of HVLA thrust due to major methodological and ethical limitations.…”

3D motion reliability of occipital condylar glide testing: From concept to kinematics evidence

“…From a biomechanical point of view, in-vitro studies reported 3D arthrokinematic features following C 1 eC 2 mobilization (Cattrysse et al, 2007(Cattrysse et al, , 2010 or upper cervical spine (UCS) manipulation (Dugailly et al, 2014a). Similarly to SMP, these authors have defined substantial intra-and inter-rater reliability for the axial rotation component (Cattrysse et al, 2009) and average regional variations (C 0 eC 2 ) reached up to 1 and 6 (Dugailly et al, 2014a).…”