The influence of cervical spine flexion-rotation range-of-motion asymmetry on postural stability in older adults

Quek, June Mei Tse, Pua, Yong-Hao, Bryant, Adam L. and Clark, Ross A. (2013) The influence of cervical spine flexion-rotation range-of-motion asymmetry on postural stability in older adults. Spine, 38 19: 1648-1655. doi:10.1097/BRS.0b013e31829f23a0

Author Quek, June Mei Tse
Pua, Yong-Hao
Bryant, Adam L.
Clark, Ross A.
Title The influence of cervical spine flexion-rotation range-of-motion asymmetry on postural stability in older adults
Journal name Spine   Check publisher's open access policy
ISSN 0362-2436
Publication date 2013-09-01
Year available 2013
Sub-type Article (original research)
DOI 10.1097/BRS.0b013e31829f23a0
Open Access Status DOI
Volume 38
Issue 19
Start page 1648
End page 1655
Total pages 8
Place of publication Philadelphia, PA United States
Publisher Lippincott Williams and Wilkins
Language eng
Abstract Study Design. Cross-sectional design. Objective. The purpose of this study was to isolate the contribution of cervical spine range-of-motion (ROM) asymmetry to postural control in a group of older adults with neck pain. Summary of Background Data. Previous research has suggested that the upper cervical spine plays an important role in postural stability. However, it remains unclear whether the upper cervical spine rotation ROM asymmetry is associated with postural stability. Methods. Using the cervical range-of-motion device to assess upper cervical spine ROM via the cervical fl exion-rotation test, we classifi ed 54 older adults with neck pain (30 females; mean [standard deviation] age, 66 [5] yr) into the (1) symmetrical group (SYM; n = 20; ≤ 5 ° side-to-side difference) or (2) asymmetrical group (ASYM; n = 34; > 5 ° difference). Standing postural control was characterized by the center-of-pressure (CoP) movements measured using a Balance Board. Other measures included habitual, fastpaced gait speed and neck pain. Both groups were compared on the various measures using Welch t tests. Results. Although the ASYM group had 26% greater anteroposterior postural sway than the SYM ( P < 0.01), both groups did not differ on postural sway velocity, gait speed, and neck pain intensity. Analyzing the frequency content of the postural sway using wavelet analysis (a modern, nonlinear signal processing method) shed further light: The standing postural sway in the ASYM group was skewed toward lower frequency movement (ultralow [ < 0.10Hz] frequency content, anteroposterior: 6.7% in ASYM, 4.7% in SYM, P = 0.01; medial-lateral: 4.2% in ASYM, 3.4% in SYM, P = 0.045). Conclusion. The ASYM group seemed to have compensated for their altered somatosensory input to achieve similar functional levels as the SYM group. Given what is known about the association between ultralow frequency postural sway and visual input, we speculated that the postural strategy adopted by the ASYM group was adaptive and that this group may be relying on the visual system to achieve these compensations. Copyright
Keyword Altered somatosensory input
Cervical spine dysfunction
Neck pain
Older adults
Postural stability
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Health and Rehabilitation Sciences Publications
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Created: Thu, 29 Oct 2015, 10:55:57 EST by June Quek on behalf of School of Health & Rehabilitation Sciences