Journal of Manipulative and Physiological Therapeutics
Volume 29, Issue 7 , Pages 570-575, September 2006

Coupling Behavior of the Cervical Spine: A Systematic Review of the Literature

  • Chad Cook, PhD, PT, MBA

      Affiliations

    • Assistant Professor, Division of Physical Therapy, Department of Community and Family Medicine, Duke University, Durham, NC
    • Corresponding Author InformationSubmit requests for reprints to: Chad Cook, PhD, PT, MBA, Assistant Professor, Division of Physical Therapy, Department of Community and Family Medicine, Duke University, Durham, NC 27710.
    • ,
  • Eric Hegedus, PT, DPT

      Affiliations

    • Assistant Clinical Professor, Duke University, DUMC 3907, Durham, NC
    • ,
  • Christopher Showalter, PT

      Affiliations

    • Clinical Director, Maitland Australian Physiotherapy Seminars, P.O. Box 1244, Cutchogue, NY
    • ,
  • Phillip S. Sizer Jr., PhD, PT

      Affiliations

    • Professor and Program Director, ScD Program in Physical Therapy, Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, Tex

Received 27 December 2005; received in revised form 22 April 2006; accepted 26 April 2006.

Abstract 

Objective

The purpose of this study was to investigate evidence of consistency of reported directional coupling patterns among selected studies and to determine its use in manual medical treatment.

Methods

The study was a systematic literature review of English-only journals using PubMed and CINAHL. The keywords included “cervical vertebrae,” “biomechanics,” “coupling,” and “three-dimensional movement” and required coupling directional assessment of individual spine segments.

Results

Four 2-dimensional and 8 3-dimensional studies met inclusion criteria. This study found 100% agreement in coupling direction (side flexion and rotation to the same side) in lower cervical vertebral segments (C2-3 and lower) and variation in coupling patterns in the upper cervical segments of occiput-C1 (during side flexion initiation) and C1-2. Dissimilarities may be explained by differences in measurement devices, movement initiation, in vivo vs in vitro specimens, and anatomical variations.

Conclusions

These findings suggest that use of 3-dimensional analyzed cervical coupling patterns for the lower cervical vertebral during apposition and treatment application may show clinical use for manual clinicians. The use of directional coupling based on 2-dimensional cervical coupling patterns or upper cervical spine coupling that addresses C1-2 should be questioned.

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PII: S0161-4754(06)00177-1

doi:10.1016/j.jmpt.2006.06.020

Journal of Manipulative and Physiological Therapeutics
Volume 29, Issue 7 , Pages 570-575, September 2006

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