The C0-C2 axial rotation test: normal values, intra- and inter-rater reliability and correlation with the flexion rotation test in normal subjects

Satpute, Kiran; Nalband, Sadaf; Hall, Toby

doi:10.1080/10669817.2018.1533195

Cited by 20 publications

(31 citation statements)

References 26 publications

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“…A recent in vivo study showed that the exion-extension of C1-2 was 13.7 ± 4.2°, accounting for 14.5% of the overall exion-extension ROM; the lateral bending neck motion of C1-2 was 7.6 ± 2.7°, accounting for 13.2% of the overall lateral bending ROM; and the axial torsion neck motion of C1-2 was 72.9 ± 7.6°, accounting for 73.2% of the overall rotation ROM [22]. Previous investigations also achieved similar results [23,24,25]. Once the motion of C1-2 joint is restricted by the anterior continuous bony bridge, the bearing force capacity from the skull and the neck is in turn reduced, which further increases the risk of cervical fracture.…”

Section: Declarationssupporting

confidence: 58%

Cervical spine fracture prediction by simple plain X-ray in ankylosing spondylitis patients after low-energy trauma

Liu

Yang

Hou

et al. 2020

Preprint

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Background Due to various reasons, the diagnosis of cervical spine fracture (CSF) in patients with ankylosing spondylitis (AS) may be missed or delayed in clinical practice.Objective To explore the prediction ability of simple plain X-ray for the possibility of CSF in AS patients who suffer from low-energy trauma (LET).Methods From January 2010 to December 2019, AS patients who experienced LET were retrospectively reviewed. Their clinical data, including gender, age, body mass index, time interval between AS diagnosis and trauma, smoking or not, and a presence of continuous bony bridge between anterior margin of C1 and C2 body or not was collected. Besides, distances and angles were measured by the lateral cervical X-ray.Results 129 AS patients were divided into Fracture group (41 cases) and Non-fracture group (88 cases) based on whether CSF existed. A total of twelve parameters had significantly statistical differences between two groups (P < 0.05). According to the binary logistic regression model, four of the twelve parameters showed a further correlation with the occurrence of CSF after LET in AS patients, namely, mean Pavlov ratio (P < 0.001, OR = 0.067), Angle D (P = 0.031, OR = 1.057), Borden’s index (P = 0.042, OR = 1.131), the time interval between the AS diagnosis and the trauma (P < 0.020, OR = 0.935). Their 95% CI were (0.023 to 0.194), (1.005 to 1.112), (0.994 to 1.287), and (0.883 to 0.990), respectively. The ROC curve and the AUC further revealed the mean Pavlov ratio had the largest AUC (0.793) (95% CI: 0.873 to 0.986), whose cut-off value was 0.72 based on the highest Youden’s index value. The optimal cut-off value, sensitivity, and specificity of the other three parameters were Angle D (45.65°, 61.0%, 78.4%), Borden’s index (9.79, 87.8%, 37.5%), and the time interval between AS diagnosis and trauma (15.50 years, 70.7%, 56.8%).Limitations The number of the included patients in the present study was relatively small.Conclusions Four parameters measured by simple X-ray show prediction ability for the occurrence of CSF in AS patients who encounter LET.

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Section: Declarationssupporting

confidence: 58%

Cervical spine fracture prediction by simple plain X-ray in ankylosing spondylitis patients after low-energy trauma

Liu

Yang

Hou

et al. 2020

Preprint

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“…Although it is considered a test to assess the rotation of the C1-2 segment, the presence of painful joints in the lower cervical spine reduced the available range in the flexion-rotation test to 37.5° [ 10 ]. This indicates that lower cervical spine pain may reduce the ROM recorded during the flexion-rotation test [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of the Manual Therapy Approach of Segments C0-1 and C2-3 in the Flexion-Rotation Test in Patients with Chronic Neck Pain: A Randomized Controlled Trial

Rodríguez-Sanz

Malo-Urriés

Lucha-López

et al. 2021

IJERPH

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Background: Flexion-rotation test predominantly measures rotation in C1-2 segment. Restriction in flexion-rotation may be due to direct limitation in C1-2, but also to a premature tightening of the alar ligament as a result of lack of movement in C0-1 or C2-3. The aim of this study was to compare the effect of a 20-min single cervical exercise session, with or without manual therapy of C0-1 and C2-3 segment in flexion-rotation test, in patients with chronic neck pain and positive flexion-rotation test. Methods: Randomized controlled clinical trial in 48 subjects (24 manual therapy+exercise/24 exercise). Range of motion and pain during flexion-rotation test, neck pain intensity and active cervical range of motion were measured before and after the intervention. Results: Significant differences were found in favour of the manual therapy group in the flexion-rotation test: right (p < 0.001) and left rotation (p < 0.001); pain during the flexion-rotation test: right (p < 0.001) and left rotation (p < 0.001); neck pain intensity: (p < 0.001); cervical flexion (p < 0.038), extension (p < 0.010), right side-bending (p < 0.035), left side-bending (p < 0.002), right rotation (p < 0.001), and left rotation (p < 0.006). Conclusions: Addition of one C0-C1 and C2-C3 manual therapy session to cervical exercise can immediately improve flexion-rotation test and cervical range of motion and reduce pain intensity.

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“…Nevertheless, with a sample size comparable to ours (upper ( n =21) and lower (n=15)), Treleaven et al showed comparable results with the joint position error test. A second reason could also be that the “axial rotation test” described by Satput et al (2019) [ 80 ] is not accurate enough and that some patients classified as having upper cervical spine pain were not.…”

Section: Discussionmentioning

confidence: 99%

Sensorimotor performance in acute-subacute non-specific neck pain: a non-randomized prospective clinical trial with intervention

Hage

Detrembleur

Dierick

et al. 2021

BMC Musculoskelet Disord

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Background The assessment of cervical spine kinematic axial rotation performance is of great importance in the context of the study of neck sensorimotor control. However, studies addressing the influence of the level of provocation of spinal pain and the potential benefit of passive manual therapy mobilizations in patients with acute-subacute non-specific neck pain are lacking. Methods A non-randomized prospective clinical trial with an intervention design was conducted. We investigated: (1) the test-retest reliability of kinematic variables during a fast axial head rotation task standardized with the DidRen laser test device in 42 Healthy pain-free Control Participants (HCP) (24.3 years ±6.8); (2) the differences in kinematic variables between HCP and 38 patients with Acute-subacute Non-Specific neck Pain (ANSP) assigned to two different groups according to whether their pain was localized in the upper or lower spine (46.2 years ±16.3); and (3) the effect of passive manual therapy mobilizations on kinematic variables of the neck during fast axial head rotation. Results (1) Intra-class correlation coefficients ranged from moderate (0.57 (0.06-0.80)) to excellent (0.96 (0.91-0.98)). (2) Kinematic performance during fast axial rotations of the head was significantly altered in ANSP compared to HCP (age-adjusted) for one variable: the time between peaks of acceleration and deceleration (p<0.019). No significant difference was observed between ANSP with upper vs lower spinal pain localization. (3) After the intervention, there was a significant effect on several kinematic variables, e.g., ANSP improved peak speed (p<0.007) and performance of the DidRen laser test (p<0.001), with effect sizes ranging from small to medium. Conclusion (1) The DidRen laser test is reliable. (2) A significant reduction in time between acceleration and deceleration peaks was observed in ANSP compared to HCP, but with no significant effect of spinal pain location on kinematic variables was found. (3) We found that neck pain decreased after passive manual therapy mobilizations with improvements of several kinematic variables. Trial registration Registration Number: NCT 04407637

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The C0-C2 axial rotation test: normal values, intra- and inter-rater reliability and correlation with the flexion rotation test in normal subjects

Cited by 20 publications

References 26 publications

Cervical spine fracture prediction by simple plain X-ray in ankylosing spondylitis patients after low-energy trauma

Cervical spine fracture prediction by simple plain X-ray in ankylosing spondylitis patients after low-energy trauma

Effects of the Manual Therapy Approach of Segments C0-1 and C2-3 in the Flexion-Rotation Test in Patients with Chronic Neck Pain: A Randomized Controlled Trial

Sensorimotor performance in acute-subacute non-specific neck pain: a non-randomized prospective clinical trial with intervention

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