Coupling behavior of the cervical spine: a systematic review of the literature.

Journal Article (Journal Article;Review;Systematic Review)

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.

Full Text

Duke Authors

Cited Authors

  • Cook, C; Hegedus, E; Showalter, C; Sizer, PS

Published Date

  • September 2006

Published In

Volume / Issue

  • 29 / 7

Start / End Page

  • 570 - 575

PubMed ID

  • 16949947

Electronic International Standard Serial Number (EISSN)

  • 1532-6586

Digital Object Identifier (DOI)

  • 10.1016/j.jmpt.2006.06.020


  • eng

Conference Location

  • United States