Estimation and age and gender-wise comparison of normative cervical range of motion using cervical range of motion (CROM) device and measure tape method in asymptomatic individuals aged between 18-40 years: A cross-sectional study

Title

Estimation and age and gender-wise comparison of normative cervical range of motion using cervical range of motion (CROM) device and measure tape method in asymptomatic individuals aged between 18-40 years: A cross-sectional study

Rationale

Previous studies demonstrated that youngest population have the greatest mobility compared to the older population. Females generally have greater cervical range of motion than males, and individuals aged 20–29 show the highest mobility with no significant age-related differences. However, individuals in the age group of 30-39 years demonstrated significant reductions in cervical motion as compared to 20–29-year-old individuals. Compared to women, males in their 30s and 40s had less mobility, whereas gender wise comparison revealed no differences in 20–29-year-old individuals. However, most of these studies are conducted in Western and other populations and have limited generalisability to our population due to differences in ethnicity, body proportions, cultural and other factors. Hence, using both the cervical range of motion device and the measuring tape method, this study aims to determine normative values for cervical range of motion and investigate if age and gender differences exist in the Indian population.

Aims and Objectives

Aim of the study:

To estimate and conduct an age and gender-wise comparison of normative cervical range of motion using cervical range of motion (CROM) device and measure tape method in asymptomatic individuals aged between 18-40 years.

Objectives of the study:

Primary objectives:

1.     To compare gender differences for cervical range of motion using cervical range of motion (CROM) device and measure tape method in asymptomatic healthy individuals aged between 18-29 years and 30-40 years of age.

2.     To compare age differences for cervical range of motion using cervical range of motion (CROM) device and measure tape method in asymptomatic healthy individuals aged between 18-29 years and 30-40 years of age.

Secondary objectives:

1.     To determine normative values of cervical range of motion using cervical range of motion (CROM) device and measure tape method in asymptotic individuals aged between 18-29 years of age.

2.     To determine normative values of cervical range of motion using cervical range of motion (CROM) device and measure tape method in asymptotic individuals aged between 30-40 years of age.

 Materials and Methodology

Study tools/materials:

1.     Measure tape

2.     Cervical range of motion (CROM) device

3.     Skin marking pencil/pen

4.     Chair/stool

Measure tape method

Cervical flexion: Mark the midpoint of the chin tip and the lower edge of the sternal notch using a skin marking pencil. Measure the distance between the mark at the lower edge of the sternal notch and the mark on the tip of the chin at the end of the range of motion. Ensure that that individual’s mouth stays closed throughout the movement.

Cervical extension: Mark the midpoint of the chin tip and the lower edge of the sternal notch using a skin marking pencil. Measure the distance between the mark at the lower edge of the sternal notch and the mark on the tip of the chin at the end of the range of motion. Ensure that the individual’s mouth stays closed throughout the movement.

Cervical lateral flexion: Mark the individual’s mastoid process and the lateral tip of the acromial process with a skin marking pencil. Ask the individual to move their head towards the shoulder. Do not allow the head to rotate, forward flex, or extend during the motion. At the end of cervical lateral flexion range of motion, measure the distance between the two markings.

Cervical rotation: Mark the acromial process and the tip of the chin with a skin marking pencil. Ask the individual to stare directly ahead before turning their head as far to the right or left side without turning their trunk. At the end of the range of motion, measure the distance between the two markings**.**

Cervical range of motion device

Two gravity inclinometers and a compass inclinometer are supported by the headpiece of the CROM device. In order to measure flexion and extension, a single gravity inclinometer is situated on the side of the head in the sagittal plane. The other gravity inclinometer is used to measure lateral flexion and is situated in the frontal plane above the forehead. The compass inclinometer, which measures rotation, is placed over the top of the head in the transverse plane and features a gravity needle. To guarantee accuracy, a neckpiece with two powerful magnets is positioned around the individual’s neck when using the compass inclinometer.

The CROM device should be carefully placed on the head of the individual so that the Velcro strap fits firmly over the back of the head and the nosepiece rests on the nose bridge. The device is universally applicable, and obtaining a good fit is quite simple for an examiner. Make sure the head is positioned such that the inclinometer on the side reads 0 degree.

Cervical flexion: Ask the individual to gently move their head forward while keeping their trunk straight. Check the inclinometer’s dial on the side of the head at the end of the range of the motion, then note the result.

Cervical extension: Ask the individual lift their chin and then bend their head back as far as they can until they encounter resistance. After the movement is complete, record the result by reading the dial on the inclinometer on the side of the head.

Cervical lateral flexion: Ask the person to tilt their head sideways without turning, extending, or moving their head forward. At the end of the movement, note the number of degrees on the dial in front of the forehead.

Cervical rotation: Position the CROM device on the individual’s head such that the nosepiece rests on the nose bridge. The magnetic yoke should be placed over the individual’s shoulders with the arrow facing north. Adjust the individual’s head such that both gravity inclinometers read 0 degrees to make sure the compass inclinometer is level. Make sure the compass inclinometer is level, then adjust the rotation meter until the pointer is zero degrees.

Tell the individual to look directly ahead and to turn their chin as much towards their shoulder as they can without bending it laterally, forward, or backward. Keep your shoulders loose, then read the inclinometer that rests over it when the movement is complete.