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. 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.

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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

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