Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May 24;11(1):10769.
doi: 10.1038/s41598-021-90306-3.

Novel assessment of the variation in cervical inter-vertebral motor control in a healthy pain-free population

René Lindstrøm  1 , Alexander Breen  2 , Ning Qu  1 , Alister du Rose  2 , Victoria Blogg Andersen  1 , Alan Breen  3
Affiliations

Novel assessment of the variation in cervical inter-vertebral motor control in a healthy pain-free population

René Lindstrøm et al. Sci Rep. .

Abstract

Spinal control at intervertebral levels is dependent on interactions between the active, passive and neural control elements. However, this has never been quantifiable, and has therefore been outside the reach of clinical assessments and research. This study used fluoroscopy during repeated unconstrained flexion and return neck movements to calculate intersegmental motor control (MC), defined as the difference and variation in repeated continuous angular motion from its average path. The study aimed to determine control values for MC at individual levels and its variability. Twenty male volunteers aged 19-29 received fluoroscopic screening of their cervical spines during 4 repetitions of neutral to full flexion and return motion. Moving vertebral images from C0-C1 to C6-C7 were tracked using cross-correlation codes written in Matlab. MC for each level was defined as the mean of the absolute differences between each repetition's angular path and their mean and its variability as represented by the SD. 1-way ANOVA and Tukey multiple comparisons were used to identify significant contrasts between levels. The mean MC differences and SDs were highest at C1-2, suggesting that this level has the least control and the most variability. Results at this level alone were highly significant (F-ratio 10.88 and 9.79 P < 0.0001). Significant contrasts were only found between C1-C2 and all other levels. The mean MC difference for summed C1-6 levels was 3.4° (0.7-6.1). This study is the first to quantify intervertebral MC in the cervical spine in asymptomatic people. Studies of neck pain patients are now merited.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Example of repeated motion paths over time at C3–C4 for one participant.
Figure 2
Figure 2
Example of repeated motion paths of C3–C4 for one participant normalised to percentage of the C2–C6 motion cycle.
Figure 3
Figure 3
Example of the mean Motor Control and its standard deviation at C3–4 for one participant.
See this image and copyright information in PMC

References

    1. Comerford MJ, Mottram SL. Movement and stability dysfunction - contemporary developments. Manual Ther. 2001;6:15–26. doi: 10.1054/math.2000.0388. - DOI - PubMed
    1. Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J. Spinal Disord. 1992;5:383–383. doi: 10.1097/00002517-199212000-00001. - DOI - PubMed
    1. Panjabi MM. The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. Clin. Spine Surg. 1992;5:390–397. - PubMed
    1. Richmond FJ, Bakker DA. Anatomical organization and sensory receptor content of soft tissues surrounding upper cervical vertebrae in the cat. J. Neurophysiol. 1982;48:49–61. doi: 10.1152/jn.1982.48.1.49. - DOI - PubMed
    1. Bahat SH, Watt P, Rhodes M, Hadar D, Treleaven J. High-vs. low-tech cervical movement sense measurement in individuals with neck pain. Musculoskelet. Sci. Pract. 2020;45:102097. doi: 10.1016/j.msksp.2019.102097. - DOI - PubMed