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
. 2025 Jul 16;10(3):269.
doi: 10.3390/jfmk10030269.

Cervical Spine Range of Motion Reliability with Two Methods and Associations with Demographics, Forward Head Posture, and Respiratory Mechanics in Patients with Non-Specific Chronic Neck Pain

Petros I Tatsios  1 , Eirini Grammatopoulou  1 , Zacharias Dimitriadis  2 , Irini Patsaki  1 , George Gioftsos  1 , George A Koumantakis  1
Affiliations

Cervical Spine Range of Motion Reliability with Two Methods and Associations with Demographics, Forward Head Posture, and Respiratory Mechanics in Patients with Non-Specific Chronic Neck Pain

Petros I Tatsios et al. J Funct Morphol Kinesiol. .

Abstract

Objectives: New smartphone-based methods for measuring cervical spine range of motion (CS-ROM) and posture are emerging. The purpose of this study was to assess the reliability and validity of three such methods in patients with non-specific chronic neck pain (NSCNP). Methods: The within-day test-retest reliability of CS-ROM and forward head posture (craniovertebral angle-CVA) was examined in 45 patients with NSCNP. CS-ROM was simultaneously measured with an accelerometer sensor (KFORCE Sens®) and a mobile phone device (iHandy and Compass apps), testing the accuracy of each and the parallel-forms reliability between the two methods. For construct validity, correlations of CS-ROM with demographics, lifestyle, and other cervical and thoracic spine biomechanically based measures were examined in 90 patients with NSCNP. Male-female differences were also explored. Results: Both methods were reliable, with measurements concurring between the two devices in all six movement directions (intraclass correlation coefficient/ICC = 0.90-0.99, standard error of the measurement/SEM = 0.54-3.09°). Male-female differences were only noted for two CS-ROM measures and CVA. Significant associations were documented: (a) between the six CS-ROM measures (R = 0.22-0.54, p < 0.05), (b) participants' age with five out of six CS-ROM measures (R = 0.23-0.40, p < 0.05) and CVA (R = 0.21, p < 0.05), (c) CVA with two out of six CS-ROM measures (extension R = 0.29, p = 0.005 and left-side flexion R = 0.21, p < 0.05), body mass (R = -0.39, p < 0.001), body mass index (R = -0.52, p < 0.001), and chest wall expansion (R = 0.24-0.29, p < 0.05). Significantly lower forward head posture was noted in subjects with a high level of physical activity relative to those with a low level of physical activity. Conclusions: The reliability of both CS-ROM methods was excellent. Reductions in CS-ROM and increases in CVA were age-dependent in NSCNP. The significant relationship identified between CVA and CWE possibly signifies interconnections between NSCNP and the biomechanical aspect of dysfunctional breathing.

Keywords: biomechanics; dysfunctional breathing; mHealth; musculoskeletal; pain.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Details of placement of both devices on a helmet fastened securely to the participants’ heads. Placement of mobile phone to the side (a), and on top (b) of the helmet.
Figure 2
Figure 2
Measurements of cervical spine ROM in flexion (a), extension (b), right- and left-side flexion (c,d), and right and left rotation (e,f).
Figure 3
Figure 3
Measurement of craniovertebral (CVA) angle with the Forward Head Posture (FHP) app.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Cohen S.P. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin. Proc. 2015;90:284–299. doi: 10.1016/j.mayocp.2014.09.008. - DOI - PubMed
    1. Safiri S., Kolahi A.A., Hoy D., Buchbinder R., Mansournia M.A., Bettampadi D., Ashrafi-Asgarabad A., Almasi-Hashiani A., Smith E., Sepidarkish M., et al. Global, regional, and national burden of neck pain in the general population, 1990-2017: Systematic analysis of the Global Burden of Disease Study 2017. Br. Med. J. 2020;368:m791. doi: 10.1136/bmj.m791. - DOI - PMC - PubMed
    1. Treede R.D., Rief W., Barke A., Aziz Q., Bennett M.I., Benoliel R., Cohen M., Evers S., Finnerup N.B., First M.B., et al. Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11) Pain. 2019;160:19–27. doi: 10.1097/j.pain.0000000000001384. - DOI - PubMed
    1. Dimitriadis Z., Kapreli E., Strimpakos N., Oldham J. Do psychological states associate with pain and disability in chronic neck pain patients? J. Back Musculoskelet. Rehabil. 2015;28:797–802. doi: 10.3233/BMR-150587. - DOI - PubMed
    1. Falla D., Jull G., Hodges P., Vicenzino B. An endurance-strength training regime is effective in reducing myoelectric manifestations of cervical flexor muscle fatigue in females with chronic neck pain. Clin. Neurophysiol. 2006;117:828–837. doi: 10.1016/j.clinph.2005.12.025. - DOI - PubMed

LinkOut - more resources