Proposal of an Alternative to the AMA Guidelines for the Evaluation of the Cervical ROM

Abstract

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The cervical spine is one of the most frequently injured joints in a car accident. References for the range of motion (ROM) that should be expected in a person are needed to stage the injuries. The two main objectives of this paper are to clinically validate a measuring device for the cervical spine, and to assess if the use of different ROM reference values will render different results from the American Medical Association (AMA) ROM guidelines. The present study is divided into 2 phases, a validation phase with 55 subjects and a case-control phase with 80 subjects. A BTS (Bioengineering Technology and System) system and the EBI-5 (estudio biomecánico integral) system were used for the present investigation. The intraclass correlation agreement value between both measuring devices is considered very good with a Cronbach alpha up to 0.9 in every dimension. Correlations (r) between variables are very high, not showing any values lower than 0.887. All comparisons between using AMA ROM guidelines or normative values presented significant differences (p < 0.05). The EBI-5 system has exhibited good accuracy being paired to a photogrammetric system. The use of guidelines adjusted to age constitute an alternative to the use of the AMA cervical ROM guidelines. Professionals should use age-normalized guidelines as an alternative to the AMA guidelines.