Cattrysse E, Provyn S, Kool P, Gagey O, Clarys J P, Van Roy P
Vrije Universiteit Brussel, Faculty of Physical Education and Physiotherapy, Department of Experimental Anatomy, Laarbeeklaan 103, B1090 Brussels, Belgium.
J Electromyogr Kinesiol. 2009 Feb;19(1):93-104. doi: 10.1016/j.jelekin.2007.06.019. Epub 2007 Aug 28.
The reproducibility of the 3-dimensional (3D) kinematic aspects of motion coupling patterns of segmental manual mobilizing techniques is not yet known. This study analyzes the segmental 3D aspects of manual mobilization of the atlanto-axial joint in vitro.
Twenty fresh human cervical specimens were studied in a test-retest situation with two examiners. The specimens were manually mobilized using three different techniques: a regional mobilization technique, a segmental mobilization technique on the atlas with manual fixation of the axis and a segmental mobilization applying a locking technique. Segmental kinematics were registered with a Zebris CMS20 ultrasound-based tracking system. The 3D aspects of motion coupling between main axial rotation and coupled lateral bending were analyzed by six parameters: the range of motion the three motion components, the cross-correlation, the ratio and the shift.
The results indicate stronger intra- than inter-examiner reproducibility. The range of motion of the axial rotation component shows a substantial level of intra- and inter-examiner reproducibility (ICC's 0.67-0.76). The parameters describing the coupling patterns show only moderate to substantial intra-examiner reproducibility for the more experienced of the two examiners (ICC's 0.55-0.68). All other correlations were not significant and no differences could be observed between regional versus segmental techniques.
Reproducibility of segmental 3D-aspects of manual mobilization of the atlanto-axial joint in an in vitro situation can differ between examiners. The results of the present study may indicate a possible tendency to higher reproducibility if mobilizations are performed by an examiner with high expertise and experience in applying the specific techniques. Continued investigation including more examiners with different levels of experience and different techniques is necessary to confirm these observations.
节段性手法松动技术运动耦合模式的三维（3D）运动学方面的可重复性尚不清楚。本研究在体外分析寰枢关节手法松动的节段性3D方面。
对20个新鲜的人体颈椎标本进行了重测，由两名检查者操作。使用三种不同技术对手标本进行手法松动：一种区域松动技术、一种在寰椎上进行节段性松动并手动固定枢椎的技术以及一种应用锁定技术的节段性松动技术。节段运动学通过基于Zebris CMS20超声的跟踪系统进行记录。通过六个参数分析主轴向旋转与耦合侧方弯曲之间运动耦合的3D方面：三个运动分量的运动范围、互相关、比率和偏移。
结果表明检查者内部的可重复性强于检查者之间。轴向旋转分量的运动范围在检查者内部和检查者之间均显示出较高的可重复性水平（组内相关系数为0.67 - 0.76）。对于两名检查者中经验更丰富的检查者，描述耦合模式的参数仅显示出中等至较高的检查者内部可重复性（组内相关系数为0.55 - 0.68）。所有其他相关性均不显著，区域技术与节段技术之间未观察到差异。
在体外情况下，寰枢关节手法松动节段性3D方面的可重复性在检查者之间可能存在差异。本研究结果可能表明，如果由在应用特定技术方面具有高专业知识和经验的检查者进行松动操作，可能存在更高可重复性的趋势。需要继续进行研究，包括更多具有不同经验水平和不同技术的检查者，以证实这些观察结果。
