Reproducibility and instrument validity of a new ultrasonography-based system for measuring cervical spine kinematics

OBJECTIVE: To report instrument validity of CMS 70P, a new ultrasonography-based system for spatial kinematic analysis of the spine and its application in studying the reproducibility of cervical motion findings in healthy subjects. BACKGROUND: Reproducibility of cervical motion has been investigated using various instruments and consisting in most cases of short test-retest time intervals of between minutes to days. METHODS: Performance of the instrument was validated against a digital inclinometer, at ranges of motion compatible with actual cervical motion. To study reproducibility, 25 healthy individuals, 22 women and 3 men aged 26-48 were tested twice within an average time interval of 3.3 weeks. Performed in the seated position and at a self-determined pace, cervical motion was defined in terms of head motion relative to a sternal (reference) system, in all six primary motions: flexion, extension, right rotation, left rotation, right lateral flexion and left lateral flexion. RESULTS: The system exhibited excellent agreement with the digital inclinometer, establishing its instrument validity for testing cervical motion. No significant differences were indicated between the test and retest for both the net maximal displacements and average velocities. The correlation coefficients for the single plane motions (e.g. flexion+extension) were higher than those derived for the primary motions, and ranged between 0.78 (sagittal plane) and 0.88 (frontal plane). The magnitude of the standard error of the measurement reflected the same trend with the lowest value recorded for the frontal plane. The self-selected velocity at which these motions were performed was similar in the frontal and saggital planes but was significantly higher for the transverse plane (rotations). CONCLUSIONS: This study indicates that spanned over time intervals that are measured in weeks, cervical motion findings derived from the CMS 70P are well reproducible. Findings also imply the need for a more stringent control of subject positioning and stabilization. RELEVANCE: Reduction of range of motion and average is typically observed in various pathologies of the cervical spine and is regarded, together with pain, as a major impairment. Therefore, valid assessment of cervical motion which is essential for follow-up and treatment outcome strongly depends on reproducibility of the findings. This study indicates that acceptable reproducibility is maintained over periods of time which are clinically meaningful using the system described herewith.