Assessment of cervical stiffness in axial rotation among chronic neck pain patients: A trial in the framework of a non-manipulative osteopathic management

• Published in: Clinical biomechanics (Bristol) 2018-03, Vol.53, p.65-71
• Main Authors: Dugailly, P.-M., Coucke, A., Salem, W., Feipel, V.
• Format: Article
• Language: English
• Subjects: Adult; Axial rotation; Biomechanical Phenomena; Cervical motion; Cervical spine; Cervical Vertebrae - physiopathology; Chronic Pain - physiopathology; Female; Humans; Male; Middle Aged; Musculoskeletal Manipulations; Neck pain; Neck Pain - physiopathology; Osteopathic treatment; Range of Motion, Articular - physiology; Rotation; Stiffness
• ISSN: 0268-0033; 1879-1271
• DOI: 10.1016/j.clinbiomech.2018.02.005

Cervical stiffness is a clinical feature commonly appraised during the functional examination of cervical spine. Measurements of cervical stiffness in axial rotation have not been reported for patients with neck pain. The purpose of this study was to investigate cervical spine stiffness in axial rotation among neck pain patients and asymptomatic subjects, and to analyze the impact of osteopathic management. Thirty-five individuals (17 patients) were enrolled. Measurements were carried out for left-right axial rotation using a torque meter device, prior and after intervention. Passive range of motion, stiffness, and elastic-and neutral zone magnitudes were analyzed. Pain intensity was also collected for patients. The intervention consisted in one single session of non-manipulative osteopathic treatment performed in both groups. A significant main effect of intervention was found for total range of motion and neutral zone. Also, treatment by group interaction was demonstrated for neutral-, elastic zone, stiffness in right axial rotation, and for total neutral zone. Significant changes were observed in the clinical group after intervention, indicating elastic zone decrease and neutral zone increase. In contrast, no significant alteration was detected for the control group. Stiffness characteristics of the cervical spine in axial rotation are prone to be altered in patients with neck pain, but seem to be relieved after a session of non-manipulative manual therapeutic techniques. Further investigations, including randomized clinical trials with various clinical populations and therapeutic modalities, are needed to confirm these preliminary findings. •Cervical stiffness was tested in axial rotation for neck pain and healthy subjects.•Effect of osteopathic non-manipulative techniques on the stiffness was assessed.•Range of motion and neutral zone were altered in patients compared to healthy subjects.•Stiffness features and pain were improved for neck pain patients•Cervical stiffness in axial rotation could provide relevant clinical information.