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Understanding the Combined Motions of the C3/C4 Vertebral Unit: A Further Look at Fryette's Model of Cervical Biomechanics

Journal: The AAO Journal Date: 2002/09, 12(3):Pages: 15-30, type of study: clinical trial

Free full text   (https://www.academyofosteopathy.org/aaoj)

Keywords:

cervical spine [210]
H. Fryette [2]
clinical trial [612]
diagnosis [263]
rotation [21]
sidebending [2]
spinal motion [2]

Abstract:

The osteopathic concept of spinal motion is predicated on the observations of Harrison H. Fryette, DO. According to his theory of spinal motion, rotation and sidebending at the segmental level in the cervical spine are coupled. The typical cervical segment demonstrates rotation and sidebending to the same side. The null hypothesis is that rotation and sidebending of a typical cervical vertebral unit will be to the same side on passive intervertebral motion testing, as demonstrated by Fryette's laws of spinal motion. The objective of this research is to experimentally test the validity of Dr. Fryette's hypothesis of coupled motion in a typical cervical vertebral unit. Specifically, motion of the third cervical vertebral unit; that is, the third cervical vertebra in relation to the fourth cervical vertebra was tested. The data collected was statistically analyzed in order to determine whether rotation and sidebending at the segmental level in the cervical spine move to the same or opposite directions. Board certified osteopathic physicians were the examiners and 289 asymptomatic adult volunteers were the subjects. For the purposes of this study coupled motion is defined as rotational and sidebending motion in the same direction while uncouped motion occurs in opposite directions. The results of experiments 1 and 2 suggest a greater frequency of uncoupled versus coupled motion at the C3 on C4 vertebral unit. Coupling occured at a lesser frequency than would have been predicted by Fryette's laws of spinal motion. A third experiment was conducted to test if repeated passive motion testing affected the outcome of interexaminer reliability in experiment 2. Conclusions, which may be drawn from this research, are that cervical vertebral motion does not concur with Fryette's theory of coupled motion and passive motion testing may affected interexaminer reliability.


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