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J Man Manip Ther. 2013 Feb;21(1):33-9. doi: 10.1179/2042618612Y.0000000017.

Comparison of cervical range of motion in two seated postural conditions in adults 50 or older with cervical pain.

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Wayne State University, Detroit, MI, USA.



The influence of self-selected unsupported seated posture on cervical range of motion (ROM) has not been widely studied. Cervical ROM in habitual (HAB) compared to erect (ER) seated posture in adults 50 or older with cervical pain was investigated.


Individuals 50 or older with chronic neck pain participated in this within-subject observational study. ROM and posture (sagittal distances from the nose to the occiput, C7, and thoracic width and relative to a projected laser plumb line) were measured with the CROM device in the two postures. Test-retest reliability, standard error of measurement (SEM) and minimum detectable change at the 95% confidence level (MDC95) were calculated.


Total planar ROM values were significantly different between HAB and ER postures. Extension, total rotation and lateral flexion, and R lateral flexion ROM were greater, while flexion decreased significantly in the ER posture. SEM% ranged from 4.0 to 9.5% and MDC95 values were lower in ER (5.8-11.6°) compared to HAB (6.6-17.7°). MDC95% was moderately low for both postures (11.2-26.2%).


ROM was significantly different between HAB and ER postures. The directions most likely to detect real change in neck mobility were rotation in both postures, and extension as well as total flexion/extension in ER. Flexion and lateral flexion should be regarded cautiously as measures of improvement. Erect posture maximizes available cervical ROM in individuals over 50 with chronic neck pain compared to habitual postures.


Cervical pain; Cervical range of motion; Minimum detectable change; Postural assessment; Postural correction

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