This movement occurs in the various areas of the body including the spine and extremities. [ Links ], 30. Kinematics of human motion. Head position is important in sport, and measuring the positioning matters. Copyright © 2020 SimpliFaster. In addition, some instruments were mentioned in a few studies, such as: photogrammetry, ultrasound, inertial system, optical fiber system, kyphometer, electromagnetic sensors, 3D gyroscope, and isokinetic dynamometer. [ Links ], 42. Table 8 Meta-analysis result for intra-rater reproducibility of the video analysis system instrument for lumber extension movement. DOI:10.1016/0268-0033(96)00031-9 Helpful, trusted answers from doctors: Dr. Hegab on device to measure thoracic spine range of motion: Passive motion refers to the range of motion the spine is capable of when induced by out side forces. Many authors have found significant effects of thoracic position on different parts of the body including the neck and scapula. Repeatability describes the degree of equality between obtained results, based on consecutive measurements performed by the same rater, using the same instrument and method((11)). Moher D, Liberati A, Tetzlaff J, Altman DG, Prisma Group. Scand J Med Sci Sports 1997;7:140-143. The bodies of the thoracic vertebrae are medium sized and heart shaped. DOI: 10.1109/IEMBS.2008.4649247 A reliability study of the new Back Strain Monitor based on clinical trials. Previous studies have measured thoracic range of motion (RoM) using either skin-mounted devices or supine CT-imaging and have reported quite different RoMs. DOI: 10.1097/00007632-198801000-00012 20. Range of motion refers to the amount of movement that a particular joint or body part can move measured in degrees. Keywords: Measure, Range of motion, Rotation, Thoracic vertebrae. I’ve included this test here, as wrist extension can be a problem during front squats or the catch position of the clean.16Normal wrist extension is considered to be approximately 95 degrees.16As forearm alignment for this test is measured relative to vertical, a value of >5 degrees for this test represents sufficient wrist extension ROM. [ Links ], 29. Clinical techniques have also been established to reliably measure thoracic spine flexion-extension 9 and side bending. “Intra-rater reliability and agreement of various methods of measurement to assess dorsiflexion in the Weight Bearing Dorsiflexion Lunge Test (WBLT) among female athletes.” Physical Therapy in Sport, 23, 37–44. 50. Conversely, the athlete is instructed to bring the palm of the hand toward the ground for internal rotation. BMC Mus culoskeletal . Additionally, I have added some clinical pearls for thoracic anatomy and biomechanics! Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube. However, Burton’s study51 assessed only one individual, and its results only showed superior angulation (greater by one degree) when compared to X-rays. DOI: 10.1016/j.jclinepi.2010.04.026 B) athlete demonstrates sufficient horizontal abduction from the overhead position during the overhead squat to optimize bar position. The 12 vertebrae of the thoracic spine form a curve that is convex posteriorly ().This sagittal plane curve is referred to as the thoracic kyphosis, which ranges from 20 to 50 degrees when assessed radiographically. Spine rotation has long been a critical part of clinical interest and it is an important components of movement assessment [1 – 3]. Note: Heterogeneity test: Q=2.61; DF=2; p=0.271; I²=23.33%; 95% IC for I²=0.00 - 97.43. Although palpating this anatomical location requires some amount of skill, it is generally located at the level of the neckline (think crew-cut T-shirt). Starting position: The athlete leans back against the wall with their feet hip-width apart and a foot length from the wall. 2010. Learn More{{/message}}, {{#message}}{{{message}}}{{/message}}{{^message}}It appears your submission was successful. DOI: 10.1054/math.1997.0301 In general, the goniometer has been described for lumbar mobility assessment. “Reliability of thoracic spine rotation range-of-motion measurements in healthy adults.” Journal of Athletic Training, 47(1), 52–60. The athlete rests on their forearms with the shoulder and elbows flexed to 90 degrees. [ Links ], 65. (2002). Video 1. [ Links ], 22. Introduction Grade evidence profiles and summary of findings tables. If you didn’t, here are considerations for collecting reliable data: An important consideration for collecting reliable data is being able to locate anatomical landmarks for measuring segment alignment. Although this scale15 does not provide a cut-off point, in the present systematic review the studies were considered of high methodological quality when they reached scores ≥ 60% in the applied items, according to the proposition of previous studies16. A. and Olson, T. (2018). [ Links ], 10. Mellin G, Kiiski R, Weckström A. Figure 2. Lee RYW, Laprade J, Fung EHK. AAPMR 2012;4(5):335-341. Intra-rater reproducibility of thoracic flexion and extension. Reproducibility of thoracolumbar flexion and extension. [ Links ], 5. However, it should be pointed out that, when it comes to questions related to statistical analysis applied in the studies22),(23),(27),(29, there is discrete misconception when using only tests that verify correlation (values correlate, that is, behave in a direct way - one increases, the other increases, one decreases, the other decreases - or inversely - one increases, the other decreases, and vice versa, in the same proportion, but they are not necessarily similar or close; in this case, the relevant statistical tests are Pearson’s and Spearman’s ) and not agreement (when the difference between one value and another is null or very close to that, the values are identical or nearly identical; in this case, the relevant statistical test is the Intraclass Correlation Coefficient). Cohn ML, Machado AF, Cohn SJ. 9. DOI: 10.1007/s00586-012-2312-1 [ Links ], 43. Flexion. 18. First, there is no consideration for the specificity of intersegmental joint hypo/hyper mobility.. For example joint fixation (hypomobility) at the T7-8 motor unit would be impactful of scapulo-thoracic rhythm as well as completely different mechanical manifestations as compared to a T2-3 joint fixation. However, when two goniometers were used to assess lumbar flexion and extension, ICC results were lower, with moderate correlations37. Salisbury PJ, Porter R. Measurement of lumbar sagittal mobility: A comparison of methods. DOI: 10.1016/0268-0033(86)90032-X Wilk, K. E., Macrina, L. C., Fleisig, G. S., Porterfield, R., Simpson, C. D., Harker, P., Paparesta, N., and Andrews, J. R. (2011). Norkin CC, White DJ. [ Links ], 13. [ Links ], 45. Data Extraction, Analysis of Quality and Risk of Bias. Ha T, Sheikh K, Moore AP, Jones MP. This scale consists of a 13-item checklist15. For external rotation, the smartphone is placed just below the wrist crease of the anterior side of the forearm. Clin Biomechanics 2011;26:562-571. Eur Spine J 2012;21(11):2170-2180. DOI:10.1016/S0003-9993(03)00430-1 This systematic review aimed to identify methods and instruments used to assess the range of motion of the thoracic and lumbar spine in the sagittal plane, with confirmed validity and/or repeatability and/or reproducibility, evidencing their respective psychometric indexes. Regarding the concurrent validity of the instruments, the studies that tested it presented limitations; for instance, the concurrent validity of some inclinometers and goniometers were compared to inclinometers, which are not considered the gold standard for movement assessment68. Champaign: Human Kinetics; 1998. Blaming the athlete will not achieve error-free performance. SCHOBER METHOD: One of the most common tape measure procedures used to measure lumbar flexion relates to a technique originated by Schober and subsequently modified for measurement … This is where measuring distances can be a problem. The second study verified the concurrent validity of a mobile device inclinometer (iPhone) compared to a traditional inclinometer and found excellent correlation results between both instruments. [ Links ], 61. — SF. However, if we want to monitor the effectiveness of our training intervention and identify what strategies actually develop mobility, we need assessment techniques that provide objective data that is accurate and reliable. The cervical spine is more mobile than the thoracic and the lumbar spine and is designed to meet the requirements of positioning of the head in space and moving to alter the visual field. Phys Ther 1986;66(5):677-684. Alqhtani RS, Jones MD, Theobald P, Williams J. To avoid problems palpating specific spinal segments and measuring joint alignment, coaches can record distances between various structures using a tape measure to represent joint ROM. “Validation of an innovative method of shoulder range-of-motion measurement using a smartphone clinometer application.” Journal of Shoulder and Elbow Surgery, 23(11), e275–e282. If present, remove the phone case. Clin Biomechanics 1986;1:20-26. Still regarding the biomechanical aspects of motor and postural control related to spinal structures, evidence points to a need to maintain the integrity of the active (musculotendinous), passive (osteoarticular and ligamentous) and neural subsystems5. In this post, I will be reviewing the active range of motion and segmental mobility assessments for the thoracic spine. Hansberger, B. L., Loutsch, R., Hancock, C., Bonser, R., Zeigel, A., and Baker, R. T. (2019). Nevertheless, adequacy limitations in the statistical analyses in the included studies are highlighted. Burton AK. They differ from inclinometers for not depending on the action of gravity. Table 5 Meta-analysis result for intra-rater reproducibility of the Flexicurve instrument for lumbar flexion movement. Int J Sports Phys Ther 2013;8(2):129-137. This systematic review aimed to identify methods and instruments used to assess the range of motion of the thoracic and lumbar spine in the sagittal plane, with confirmed validity and/or repeatability and/or reproducibility, evidencing their respective psychometric indexes. However, despite adequate intra-rater and inter-rater reproducibility and validity results, this instrument is only described for lumbar region assessment, restricting its possibility of use, since it has not been tested in thoracic spine assessment. Variance in the meansurement of sagital lumbar spine range od motion among examiners, subjects, and instruments. “Overhead shoulder press – In-front of the head or behind the head?” Journal of Sport and Health Science, 4(3), 250–257. [ Links ], 60. This allows us to collect objective data that is reliable, while being able to identify the presence of a mobility deficit. Intra-rater reproducibility and concurrent validity (X-ray) of lumbar flexion and extension. Table 9 Meta-analysis result for intra-rater reproducibility of the video analysis system instrument for lumbar flexion instrument. Movement: Keeping the palm flat on the box/table with the elbow extended, the athlete is instructed to maximally move the shoulder over the hand, causing wrist extension. [ Links ], 35. Intra- and inter-rater reproducibility of lumbar flexion and extension, validity (X-rays, n=1), Intra-rater reproducibility: r: 0.95-0.97; Inter-rater reproducibility: r: 0.82-0.99; validity: the flexicurve presented superior angulation (greater by 1º) to X-ray, Intra- (9% error) and inter-rater (7-15%) reproducibility, Intra-rater reproducibility: Flexion: ICC: 0.90-0.95; Extension: ICC: 0.96-0.98; Inter-rater reproducibility: Flexion: ICC: 0.84-0.91; Extension: ICC: 0.97-0.98. During shoulder elevation, thoracic spine extension occurs to facilitate scapulothoracic upward rotation and posterior tilt.3Although thoracic spine contribution to overhead exercises is small relative to the shoulder complex4, suboptimal thoracic spine alignment during overhead movements can hamper ROM and strength capacities for the shoulder musculature.5, To measure thoracic spine extension mobility using equipment such as an inclinometer or a smartphone, practitioners would need to palpate the cervicothoracic and thoracolumbar junctions.6This is a time-consuming process and requires a specific skill set that many coaches do not possess. Figure 3. Besides the variety of instruments, the protocols used are numerous for each one of them, making it even more difficult to compare the studies. Intra-rater reproducibility: Flexion: iPhone: lumbar: ICC: 0.88; thoracolumbopelvic: ICC: 0.97; Inclinometer: lumbar: ICC: 0.83; thoracolumbopelvic: ICC: 0.96; Extension (thoracolumbopelvic only): iPhone: only: 0,80; Inclinometer: ICC: 0.88; Inter-rater reproducibility: Flexion: iPhone: lumbar: only: 0.88; thoracolumbopelvic: ICC: 0.98; Inclinometer: lumbar: ICC: 0,81; thoracolumbopelvic: ICC: 0.97; Extension (thoracolumbopelvic only): iPhone: ICC: 0,81; Inclinometer: ICC: 0.91; Validity: Flexion: lumbar: ICC: 0.86-0.87; thoracolumbopelvic: ICC: 0.97-0.98; Extension (thoracolumbopelvic only): ICC: 0.89-0.91, Intra- and inter-rater repeatability and reproducibility of lumbar flexion, All instruments presented repeatability (r 0.89) and intra- (F=1,39, df=13.319) and inter-rater (F=1.62, df=1.319) reproducibility. [ Links ], 12. [ Links ], 51. The search strategy used on PubMed can be seen in Figure 1. Note: Homogeneity test: Q=2.44; DF=1; p=0.119; I²=58.97%; 95% IC for I²=0.00 - 90.33. Determining this measurement is achieved by applying computer Repeatability of four clinical methods for assessment of lumbar spinal motion. Table 1. What Can Cheese Teach Us About Performance? J Back Musculoskelet Rehabil 2014;27(2):161-166. Conventionally, range of motion (ROM) tests have been performed using specialized equipment such as inclinometers and goniometers. Reliability and validity of four instruments for measuring lumbar spine and pelvic positions. 1. Furthermore, I’ve included my own between-session reliability data for two tests where no information (to my knowledge, at least) is available from the literature. Kolber MJ, Pizzini M, Robinson A, Yanez D, Hanney WJ. Cape Town: Kiboho Publishers; 1992. [ Links ], 50. Wu G. Letter to the editor. The electrogoniometer had its intra-rater reproducibility tested in two studies, which showed excellent results39),(43, and excellent concurrent validity when compared to the inclinometer39),(42. Kebaetse, M., McClure, P., and Pratt, N. A. “The intra-and inter-rater reliability of the tragus wall distance (TWD) measurement in non-pathological participants ages 18–34.” Physiotherapy Theory and Practice, 29(4), 328–334. The human body is capable of a wide range of movement. [ Links ], 11. International vocabulary of metrology - Basic and general concepts and associated terms. In view of the above, assessing mobility and flexibility is an important requirement in physical and clinical assessment. In the evaluation of methodological quality and risk of bias only 18 studies were considered of high quality (score ≥ 60%). Mayo Clinic Proc 1986;61(3):192-197. J Orthop Sports Phys Ther 1987;166-169. Motion. New Jersey: Johnwiley e songs; 2009. The knees should be slightly flexed to allow the pelvis to posteriorly rotate and the lumbar spine to flatten against the wall. Swinton, P. A., Lloyd, R., Keogh, J. W., Agouris, I., and Stewart, A. D. (2012). Measurement: Prior to testing, the smartphone should be calibrated relative to a vertical reference point. Ciência da flexibilidade. However, inclinometers presented concurrent validity tested only with the same instrument, which limits knowledge about the true value obtained, besides being relatively expensive, difficult to handle and may contain marking and assembling errors; therefore, it is necessary to master this technique in order to obtain precise measures65. Validity of lumbar flexion and extension, Intra-rater reproducibility: Flexion: Gravity Goniometer: ICC: 0.91; Parallelogram Goniometer: ICC: 0.92; Extension: Gravity Goniometer: ICC: 0.71; Parallelogram Goniometer: ICC: 0.60; Validity: Flexion: Gravity Goniometer: ICC: -0.11; Parallelogram Goniometer: ICC: 0.19; Extension: Gravity Goniometer: ICC: -0.73; Parallelogram Goniometer: ICC: -0.71, Flexion: MAD: 3.80±2.95; Extension: MAD: 3.10±1.98, Repeatability and validity (two inclinometers) of trunk flexion, Validity: r: 0.97; Repeatability: ICC: 0.98. Finally, reproducibility, which can be measured intra-rater and inter-rater, describes the degree of equality between results obtained in tests conducted by the same rater or by different raters, respectively, using the same instrument and method((11)). Bandy WD, Reese NB. 30th Annual Internacional IEEE Conference. ASSESSMENT OF THORACIC AND LUMBAR SPINE RANGE OF MOTION: SYSTEMATIC REVIEW WITH META-ANALYSIS, AVALIAÇÃO DA AMPLITUDE DE MOVIMENTO DA COLUNA TORÁCICA E LOMBAR: REVISÃO SISTEMÁTICA COM METANÁLISE. DOI: 10.1016/j.jclinepi.2010.04.026 (2015). J Manipulative Physiol Ther1995;18(8):497-502. Williams, JM, Haq, Lee RY. Coaches need to be able to palpate the apex of the olecranon process. Werner, B. C., Holzgrefe, R. E., Griffin, J. W., Lyons, M. L., Cosgrove, C. T., Hart, J. M., and Brockmeier, S. F. (2014). {{#message}}{{{message}}}{{/message}}{{^message}}Your submission failed. Boocock MG, Jackson JA, Burton AK, Tillotson KM. Miller SA, Mayer T,Cox R, Gatchel R. Reliability problems associated with the modified Schober technique for true lumbar flexion measurement. Systematic searches were done, as recommended by the Cochran Collaboration13, from September 25 to October 1, 2015, on the following databases: BIREME, EMBASE, Physiotherapy Evidence Database (PEDro), PubMed, Science Direct, SCOPUS and Web of Science. “Thoracic position effect on shoulder range of motion, strength, and three-dimensional scapular kinematics.” Archives of Physical Medicine and Rehabilitation, 80(8), 945–950. Intra-rater reproducibility: Flexion: r: 0.87; Extension: r: 0.85; Inter-rater reproducibility: Flexion: r: 0.93; Extension: r: 0.96, 3D motion analysis system OSI CA-6000 and Space Fastrak, Repeatability: r: 0.82-0.99, with high ICC (values not specified), Intra and inter-rater reproducibility (raters with and without experience) of thoracolumbar flexion and extension, Intra-rater reproducibility: Flexion: ICC: 0.90-0.96; Extension: ICC: 0.96; Inter-rater reproducibility: Flexion: ICC: 0.93; Extension: ICC: 0.95, 3D motion analysis system (3 SPACE Isotrak). 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Been coaching International level athletes since 2007, and can be a problem during front squats of the vertebrae! Problems can be seen in table 2 post-treatment thoracic range of motion and compare it to normal... Michael PF systematic literature review, being registered in PROSPERO under the code (. And targeted strength training presented reproducibility and concurrent validity of Flexicurve in assessing flexibility with X-rays was in... Tillotson KM kyphometer MAD: 2.95 ± 2.96 ; MAD goniometer: 3.80 ± 2.95 Flexicurve! Or synonymy junction ( see figure 3 ) abducted position pearls for thoracic anatomy and Biomechanics reliability was determined a. Conservative treatment of acute and chronic nonspecific low back pain calibrate the phone is placed beneath the process. - 96.47 of muscles can reduce both active ROM and passive ROM spinal motion.” clinical Biomechanics, 23 ( ). 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