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Tsai S-Y1,2, Chai H-M1, Chu M-M1, Wang S-F1
1National Taiwan University, School and Graduate Institute of Physical Therapy, Taipei, Taiwan, 2Cathay General Hospital, Physical Medicine and Rehabilitation, Taipei, Taiwan
Background: Cervicogenic headache is pain referred from musculoskeletal structure of neck, and the preference is 20% in population of patients with chronic headache. Restricted mobility and pain in upper cervical joints is one of the clinical features of cervicogenic headache. However, the results of previous studies those compared the range of motion within upper cervical segments between patients with cervicogenic headache and asymptomatic subjects were controversial, probably due to methodology limitation.
Purpose: The purpose of this study was to compare the movements of upper cervical region and the mobility of C0-1 segment between population with cervicogenic headache and asymptomatic ones.
Methods: The study used two methods: 1) ultrasound-based motion analysis system (CMS 70P, Zebris system) to measure movements (including: nodding, chin-up and rotation to right and left) which were generated from upper cervical segments by manual fixation below C2 (ICC3,3 range 0.85 to 0.93); 2) ultrasonography (Terason t3000) was used to record the distance change between occiput and the first cervical vertebrae during craniocervical flexion, which presenting the mobility derived from C0 and C1 on sagittal plane (ICC3,3 range 0.90 to 0.97) . Movements of upper cervical region were compared between 15 patients with cervicogenic headache and 15 asymptomatic people.
Results: The results revealed that significant difference in the distance change between C0 and C1 during craniocervical flexion (p 0.005). However, no difference was noted between these two groups in ROM of upper cervical segments.
Conclusion(s): Patients with cervicogenic headache having more restrictive movement in C0-C1 segment than asymptomatic subjects.
Implications: This study used ultrasonography other than previous method using radiographic images to detect hypomobility of C0-C1 segment in patient with cervicogenic headache. It is appropriate to document the condition of the patient, and quantify the possible treatment after manual technique.
Keywords: Cervical mobility, Ultrasonography, Cervicogenic headache
Funding acknowledgements: NSC 97-2314-B-002-011-MY3
Purpose: The purpose of this study was to compare the movements of upper cervical region and the mobility of C0-1 segment between population with cervicogenic headache and asymptomatic ones.
Methods: The study used two methods: 1) ultrasound-based motion analysis system (CMS 70P, Zebris system) to measure movements (including: nodding, chin-up and rotation to right and left) which were generated from upper cervical segments by manual fixation below C2 (ICC3,3 range 0.85 to 0.93); 2) ultrasonography (Terason t3000) was used to record the distance change between occiput and the first cervical vertebrae during craniocervical flexion, which presenting the mobility derived from C0 and C1 on sagittal plane (ICC3,3 range 0.90 to 0.97) . Movements of upper cervical region were compared between 15 patients with cervicogenic headache and 15 asymptomatic people.
Results: The results revealed that significant difference in the distance change between C0 and C1 during craniocervical flexion (p 0.005). However, no difference was noted between these two groups in ROM of upper cervical segments.
Conclusion(s): Patients with cervicogenic headache having more restrictive movement in C0-C1 segment than asymptomatic subjects.
Implications: This study used ultrasonography other than previous method using radiographic images to detect hypomobility of C0-C1 segment in patient with cervicogenic headache. It is appropriate to document the condition of the patient, and quantify the possible treatment after manual technique.
Keywords: Cervical mobility, Ultrasonography, Cervicogenic headache
Funding acknowledgements: NSC 97-2314-B-002-011-MY3
Topic: Musculoskeletal: spine
Ethics approval required: Yes
Institution: NTUH, National Taiwan Universtiy Hospital
Ethics committee: IRB, institutional review board
Ethics number: 201007004R
All authors, affiliations and abstracts have been published as submitted.
