A clinical method for measuring segmental flexion mobility in the cervico-thoracic spine and a model for classification

Abstract

Pain and limitation of spinal mobility are symptoms frequently reported by patients. Many methods have been used to assess the total range of mobility in the different parts of the spine, but there is no method for clinical examination of segmental mobility. The aim of this study was to describe such a technique concerning of segmental flexion mobility in the cervico-thoracic spine, C7-T5, and to present a model for classification of mobility. The results of this study show that the relative flexion mobility examined, according to the Cervico-Thoracic-Ratio technique (CTR), may become a valuable complement to conventional methods of assessing mobility in the cervical spine. The normalized CTR values are less influenced by the individual factors age, body weight, height and number of years at work and the classification model presented makes functional analysis of segmental flexion mobility in the cervico-junction and upper thoracic spine more substantial

Thoracic Spine Mobility and Posture: Correlation and Predictive Values in Physically Independent Older Adults

“…We found a linear regression similar to ours in the study by Norlander et al (1995). They validated the use of a tape measure for skin distraction (Schober's test) in assessing segmental mobility of the thoracic spine using the inclinometer (n = 42) and found a positive linear relationship between spine flexion mobility at the T1 and T8 level (in degrees) and Schober's test (in centimeters) (R 2 = .48; p < .001; R 2 = .44; p < .001), data similar to the results found in our study.…”

“…However, the method is commonly applied in the lumbar region, but the thoracic Schober test is less studied, and despite being a validated and low-cost clinical tool, few studies correlate the Schober test with other chest spine evaluation instruments, such as the inclinometer. Despite the scarcity of studies that have evaluated thoracic spine mobility, we found a similar correlation and simple linear regression results between the Schober test and the inclinometer for thoracic spine mobility in the study by Norlander et al (1995). Despite being older, this study provides a relevant clinical method to measure the distribution of segmental flexion of mobility in the thoracic spine.…”

“…To obtain measurements of thoracic spine segmental mobility, the thoracic spine was divided into three levels: upper thoracic at the level of the first thoracic vertebra (T1), middle thoracic at the level of the eighth thoracic vertebra (T8) and lower thoracic at the level of the 12th thoracic vertebra (T12). To ensure the correct measurement of these levels, the spinous processes of T1, T8, and T12 were located first, as suggested by Norlander et al (1995), where first the last cervical vertebra (C7) is palpated and, with the aid of the tape measure, 15 cm is counted to reach T5. Thereafter, every 3 cm, there is a new spinous process of the thoracic spine.…”

“…Analyses by video systems (3D optoelectronics) are considered the gold standard (Negrini et al, 2016). However, the high cost of acquisition, the need for a controlled space, and specialized evaluators make the method clinically unfeasible (Määttä et al, 2022;Norlander et al, 1995;Takatalo et al, 2020). On the other hand, simpler and clinically applicable methods have been investigated in the literature, including the digital inclinometer, which quantifies spine mobility in degrees, and the Schober test, which measures spine mobility in centimeters.…”

Assessing validity of thoracic spine rotation range of motion measurement methods: comparison of magnetic resonance imaging and clinical measurements

“…When the thoracic spine has limited rotational ROM, substantial movement from the scapulothoracic and glenohumeral joints is required, causing muscle and strength imbalances and an elevated risk of injury 7 ) . Furthermore, there are documented cases of thoracic spine hypomobility contributing to neck symptoms 8 , 9 ) and low back pain 10 ) . These findings emphasise the interconnectedness of spinal health and potential ripple effects throughout the musculoskeletal system.…”