新規理学療法ジャーナル

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A Novel Cervical Range of Motion Test to Measure Restricted Combined Movements. Preliminary Pre-Post Intervention Study

Hildur Laxdal, Eythor Kristjansson, Gudny L Oddsdottir and Magnus K Gislason

Background: Neck stiffness and limited range of motion in the neck can be painful and can impede performing activities of daily living (ADL). General cervical range of motion (CROM) tests are considered accurate assessment of neck movements. However, traditional CROM tests are performed in the sagittal, transverse and frontal planes but neck movements performed in ADL involves mostly combined movements. The CROM-Quarter test is a brand-new test which measure in which of the four quarter(s) or quadrant(s) patient with neck pain has the most restricted movements in 2-dimensional space. Consequently, the clinician can direct the mobilizing treatment more precisely to the movements of the most restricted cervical quadrant(s) and essentially give more effective treatment and potentially shorten the treatment period.

Objective: To ascertain if CROM-Quarter test can be used pre- and post- intervention to document the effects of a single mobilizing treatment session in clinical practice.

Methods: Twenty individuals, ages 18-50 years, with a primary complaint of stiff neck participated. An experienced physical therapist performed the mobilizing treatment for 30 minutes but participants were measured with the CROMQuarter test immediately before and after treatment of the single most restricted quadrant at the time of the visit. The Oculus Go, a virtual reality headset, was used in this study. The reason was that CROM is too large to perform movements and use a computer screen, therefore the participants had the screen on the head (in front of their eyes) to be able to perform maximal movements of their necks.

Results: Percent increase in area of x and y co-ordinates on the computer screen were calculated, which consists of the total area that an individual could cover within each area (quarter). Paired t-test showed significant difference between pre-post measurements (p<0.001) or mean 106% ± 38% improvement. The intra-rater reliability was moderate – excellent.

Conclusion: The results indicated that the CROM-Quarter test can be used to document the effects of a single mobilizing treatment session in clinical practice. Quantifying the progress and outcome of clinical care after each treatment session contributes to value-based health care, which is very much requested in the Western world.