A photographic method for multi-plane assessment of adolescent posture.

To date there have been no photographic methods reported for assessing the standing postural alignment in a manner that can be used in large scale populations. The purpose of this study was to describe a photographic, multi-plane postural measurement method in a pilot group of subjects in a school setting. A total of 83 healthy male adolescents, volunteered for the study, were photographed. The mean age was 14.5 +/- 0.7 years (range 14-16). The mean height was 170.7 +/- 3.5 cm, (range 155-187), and the mean weight was 63.2 +/- 13.9 kg (range 37-110). During procedure, subjects stood on a platform, with specific markers placed on landmarks that could be identified photographically. Photography was accomplished from above, below, each side, and front and back. These six photographs permit views to be projected onto the six sides of an ideal parallelepiped enclosing the body. Five angles were calculated and reported to describe the alignments of the head, shoulders, torso, and pelvis. As expected the means of each of the five angles were small, the absolute value varying from 0 to 7 degrees. This paper describes the results of a simple, practical, and effective way to gather data concerning standing postural alignment in adolescents using a photographic technique. This technique will be used to form a normative database by large-scale studies. Using this approach, a number of angles can be calculated and eventually models can be developed, relating these angles to sitting posture measurements and to symptoms.

Cervical spine segmental vertebral motion in healthy volunteers feigning restriction of neck flexion and extension.

The purpose of this study was to obtain comparative data concerning the percentage contribution of segmental cervical vertebral motion to the cervical range of motion (ROM) in healthy volunteers under two conditions: (1) normal, voluntary neck flexion and extension and (2) feigned restriction of neck flexion and extension. Each healthy subject's angular motion over forward cervical flexion and extension was measured first by X-ray analysis during normal, voluntary motion. Then the subjects were asked to pretend that they had a 50% restricted neck range due to pain or stiffness and thus to move in both flexion and extension only as far as about 50% of their normal range. A total of 26 healthy subjects (ten males and sixteen females, age 28.7+/-7.7 years) participated. The total angular motion from C2 to C7 was normal in the unrestricted condition and was significantly reduced in the feigned restriction condition (p<0.001). The percentage contribution of each of the functional units C2-C3 to C6-C7 to this rotation was different between the normal unrestricted and the feigned restricted conditions. In the feigned restricted neck flexion and extension, a shift occurred in the pattern of how each segment contributes to the total angular range. A greater percentage contribution was made by C2-C3 and C3-C4 than under normal conditions (P<0.01), and the percentage contribution to total rotation made by C6-C7 became much less under the feigned restricted movements than under normal, unrestricted neck range (p<0.001). Thus, simulated or feigned restricted neck ROM affects the percentage contribution of the functional units C2-C3 to C6-C7 by showing a higher percentage contribution of the upper cervical segments and less contribution to the angular rotation by the lowest cervical segment. Feigners of restricted neck range thus produce a pattern different from nonfeigning subjects.

Segmental vertebral motion in the assessment of neck range of motion in whiplash patients.

The purpose of this study was to obtain comparative data concerning the relative contribution of segmental cervical vertebral motion to the cervical range of motion (ROM) in whiplash and healthy subjects in an effort to evaluate the usefulness of X-ray analysis in future forensic and research efforts. Each subject's neck ROM was measured with an optoelectronic system and also by X-ray measurements of the angular rotation in flexion and extension. The X-rays were examined to calculate the angular movement in the sagittal plane of each of the functional units C2-C3 to C6-C7. The chronic whiplash subjects showed reduced total neck range in all directions as compared to healthy subjects (p<0.001). There was a reduced total angular rotation from flexion to extension between these two groups (p<0.01), but no significant difference, however, between chronic whiplash subjects and controls in the percentage contribution of each of the functional units C2-C3 to C6-C7 to this rotation. This data will now allow a design of trials where healthy subjects are asked to simulate restricted neck ROM while undergoing optokinetic and X-ray evaluation of segmental vertebral motion. We will be able to determine if simulators produce a similar pattern to chronic whiplash and healthy, non-simulating subjects, and thus determine if, at least for forensic and research purposes, this technique is useful in validating reported restricted neck range.