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Active Head and Cervical Range of Motion: Effect of Age in Healthy Females

Tommasi, Davide G., MS, PhD*; Foppiani, Anna C., BSc*†; Galante, Domenico, PED, PhD*; Lovecchio, Nicola, PED, PhD*; Sforza, Chiarella, MD*

doi: 10.1097/BRS.0b013e3181afe826
Cervical Spine

Study Design. A study on active cervical range of motion (RoM) in healthy females of different ages.

Objective. Perform a three-dimensional quantitative analysis of active head-cervical RoM in healthy females to assess the relationship with age.

Summary of Background Data. Age-related variations in active cervical RoM are still partially unknown: some investigations demonstrated that age has no effect whatsoever on the primary movements, whereas other studies found an inverse proportionality between age and cervical RoM.

Methods. Three groups of females were compared: 22 aged 15 to 18 years (adolescents), 25 aged 20 to 30 years (young adults), and 16 aged 35 to 45 years (mid-aged women). Active flexion and extension, lateral bending and axial rotation were recorded via an optoelectronic system. After the mathematical exclusion of thoracic movements, cervical RoM was referred to head local reference system and calculated using the tilt/twist method. Data were compared using analysis of variance.

Results. Flexion and extension were larger in the adolescents (137°) than in the young adults (128°) and mid-aged women (127°). Lateral bending had similar ranges in the 3 groups: 103° for adolescents, 101° for young adults, and 100° for mid-aged women. Axial rotation had similar ranges in the adolescents and in the mid-aged women (143°) and a slightly larger range in the young adults (151°). Primary movements were always associated with out-of-plane components.

Conclusion. In healthy females, between 15 and 45 years old, cervical RoMs in the principal planes decrease (except for rotation), but these variations are not statistically significant (P > 0.05).

Three-dimensional quantitative analysis of active head-cervical range of motion (RoM) in healthy females between 15 and 45 years old. Cervical movements recorded via an optoelectronic system, RoM calculated using the tilt/twist method, and data compared using analysis of variance. The cervical RoMs decrease with age but without statistical significance (P > 0.05).

From the *Dipartimento di Morfologia Umana e Scienze Biomediche “Città Studi,” Laboratorio di Anatomia Funzionale dell’Apparato Locomotore, Functional Anatomy Research Center, Università degli Studi di Milano, Italy; and †Dipartimento di Bioingegneria, Politecnico di Milano, Milano, Italy.

Acknowledgment date: November 23, 2008. Revision date: January 20, 2009. Acceptance date: January 20, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

The authors D.G.T. and A.C.F. equally contributed to this article.

The research detailed in this article comply with the current Italian laws and was regularly approved by the local ethics committee.

Address correspondence and reprint requests to Chiarella Sforza, MD, Dipartimento di Morfologia Umana, via Mangiagalli 31, I-20133 Milano–Italy; E-mail

© 2009 Lippincott Williams & Wilkins, Inc.