Does an increase in active cervical rotation when sitting posture is corrected indicate the need for postural re-education?
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Does an increase in active cervical rotation when sitting posture is corrected indicate the need for postural re-education? Tuttle NA, Newsham-West R, Offord S Griffith University, Gold Coast In the spirit of Mythbusters, we used a pragmatic approach to investigate assumptions underlying some aspects of clinical practice. Improvement in active rotation of the cervical spine when the patient's posture is 'corrected' is often included as part of a physical assessment. We set out to determine if this improvement in active movement is a normal response rather than indicative of the need for postural re-education. Active cervical rotation was measured in three postures using a tri-axial orientation sensor in ten asymptomatic volunteers. Rotation in upright sitting was compared with sitting in a slumped posture and upright sitting and with the shoulders elevated. There was a significantly greater rotation in the upright sitting than in the slumped position (p =0.02) of 6.5 degrees (CI 0.1 to 12.9). There was a significant increase in rotation with the shoulders elevated (p=0.01). The seven of the subjects that had an improvement in rotation increased by an average increase of 11.2 degrees (CI 7.1 to 15.3 degrees) which is comparable to the increase reported in the literature for symptomatic patients. Possible causes of these differences will be discussed. Pain responses could not be assessed in our asymptomatic population, but it is suggested that any changes in either range of motion or pain in a patient population need to be greater than the changes in movement that occur with an asymptomatic population before the therapist would be justified in drawing conclusions on the need for postural re-education.
APA Conference Week 2009
© 2009 Australian Physiotherapy Society. This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal website for access to the definitive, published version.