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Effectiveness of Cervical Spine Stabilization Techniques

Boissy, Patrick PhD*†; Shrier, Ian MD, PhD; Brière, Simon MScA; Mellete, Jay MSc, ATC§; Fecteau, Luc PT§; Matheson, Gordon O MD, PhD; Garza, Dan MD; Meeuwisse, Willem H MD, PhD; Segal, Eli MD**††; Boulay, John EMT, CAT(C), DO(Qc)‡‡; Steele, Russell J PhD§§

Clinical Journal of Sport Medicine: March 2011 - Volume 21 - Issue 2 - p 80-88
doi: 10.1097/JSM.0b013e31820f8ad5
Original Research

Objective: To compare head motions that occur when trained professionals perform the head squeeze (HS) and trap squeeze (TS) C-spine stabilization techniques.

Design: Cross-over design.

Participants: Twelve experienced lead rescuers.

Main Outcome Measures: Peak head motion with respect to initial conditions using inertial measurement units attached to the forehead and trunk of the simulated patient. We compared both HS and TS during lift-and-slide (L&S) and log-roll (LR) placement on spinal board, and agitated patient trying to sit up (AGIT-Sit) or rotate his head (AGIT-Rot). The a priori minimal important difference (MID) was 5 degrees for flexion or extension and 3 degrees for rotation or lateral flexion.

Results: The L&S technique was statistically superior to the LR technique. The only differences to exceed the MID were extension and rotation during LR (HS > TS). In the AGIT-Sit test scenario, differences in motion exceeded MID (HS > TS) for flexion, rotation, and lateral flexion. In the AGIT-Rot scenario, differences in motion exceeded MID for rotation only (HS >TS). There was similar intertrial variability of motion for HS and TS during L&S and LR but significantly more variability with HS compared with TS in the agitated patient.

Conclusions: The L&S is preferable to the LR when possible for minimizing unwanted C-spine motion. There is little overall difference between HS and TS in a cooperative patient. When a patient is confused, the HS is much worse than the TS at minimizing C-spine motion.

From the *Department of Surgery, School of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada; †Research Centre on Aging, CSSS-IUGS, Sherbrooke, Quebec, Canada; ‡Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; §Cirque du Soleil, Las Vegas, Nevada; ¶Division of Sports Medicine, Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, California; ‖Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada; **Emergency Department, Jewish General Hospital, McGill University; Montreal, Quebec, Canada; ††Urgences-santé, Montreal, Quebec, Canada; ‡‡Department of Exercise Science/Athletic Therapy, Concordia University, Montreal, Quebec, Canada; and §§Department of Mathematics and Statistics, McGill University, Montreal, Quebec, Canada.

Submitted for publication July 12, 2010; accepted January 10, 2011.

Supported by the Canadian Academy of Sport & Exercise Medicine.

The authors report no conflicts of interest.

Corresponding Author: Ian Shrier, MD, PhD, Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, 3755 Cote Ste-Catherine, Montreal, Quebec H3T 1E2, Canada (e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.