University of Bristol, Department of Orthopaedic, University Hospitals Bristol NHS Foundation Trust, Bristol Royal Infirmary, Bristol, United Kingdom.
Spine (Phila Pa 1976). 2010 Sep 1;35(19):E976-80. doi: 10.1097/BRS.0b013e3181cd6176.
Experimental study. Cervical range of motion (CROM) was measured using different clinical methods.
To compare the reliability and accuracy of visual estimation, tape measurement, and the universal goniometer (UG) with that of the CROM goniometer in measuring active CROM in healthy volunteers. The secondary objective was to identify the single neck movement that best represents overall range of motion.
Neck movement is affected by pathology in the spine and shoulder. A reliable and accurate measurement of neck movement is required to quantify injury, recovery, and disability. Various methods of measuring neck movement have been described of which radiography remains the accepted reference standard. However, radiography is impractical for routine clinical assessment. Visual estimation, tape measurement, and the UG are convenient alternatives. To date, the accuracy and reliability of these methods have not been compared in healthy subjects, and the single neck movement that best reflects overall range has not yet been identified.
Active cervical flexion, extension, right and left lateral flexion and rotation were measured in 100 healthy volunteers. Visual estimation, tape measurement between fixed landmarks, and the UG aligned on fixed and anatomic landmarks were compared with the CROM goniometer, which was used as the reference standard.
Compared with the CROM goniometer, the UG aligned on fixed landmarks was the most accurate method, followed by the UG on anatomic landmarks. The reliability of the UG was between substantial and perfect. Visual estimation was reproducible but measured range of movement inaccurately. Tape measurement was inaccurate. Extension best reflected overall range.
The UG aligned on a fixed landmark is most reliable method of measuring neck movement clinically. Where range must be quickly assessed, extension should be measured.
实验研究。使用不同的临床方法测量颈椎活动度（CROM）。
比较视觉估计、胶带测量和通用量角器（UG）与 CROM 量角器在测量健康志愿者主动 CROM 时的可靠性和准确性。次要目的是确定最能代表整体运动范围的单个颈部运动。
颈部运动受脊柱和肩部病变的影响。需要可靠且准确的颈部运动测量来量化损伤、恢复和残疾。已经描述了多种测量颈部运动的方法，其中 X 光摄影仍然是公认的参考标准。然而，X 光摄影不适用于常规临床评估。视觉估计、胶带测量和 UG 是方便的替代方法。迄今为止，这些方法在健康受试者中的准确性和可靠性尚未得到比较，也尚未确定最能反映整体运动范围的单一颈部运动。
在 100 名健康志愿者中测量颈椎主动前屈、后伸、左右侧屈和旋转。将视觉估计、固定标志之间的胶带测量以及固定和解剖标志上的 UG 与 CROM 量角器进行比较，CROM 量角器作为参考标准。
与 CROM 量角器相比，固定标志上的 UG 是最准确的方法，其次是解剖标志上的 UG。UG 的可靠性在实质性和完美之间。视觉估计具有可重复性，但测量运动范围不准确。胶带测量不准确。伸展最能反映整体运动范围。
在临床测量颈部运动时，固定标志上的 UG 是最可靠的方法。在需要快速评估范围的情况下，应测量伸展度。
