Alternative Medicine Research Today is a free monthly online journal that collates and summarizes the latest research about Alternative Medicine, including details on complementary medicine, alternative therapies, homeopathy. | ||||||||
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Coupling behavior of the cervical spine: a systematic review of the literature.Cook C, Hegedus E, Showalter C, Sizer PS Division of Physical Therapy, Department of Community and Family Medicine, Duke University, Durham, NC 27710, USA. chad.cook@duke.edu 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. Published 4 September 2006 in J Manipulative Physiol Ther, 29(7): 570-5.
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