Dynamic Chiropractic - September 6, 1999, Volume 17, Issue 19|
Life West Researchers Report Establishing Reliable Spinal ROM Measurements
Contrasts the AMA's Spinal ROM Guides that Were Judged Unreliable
A research team at Life Chiropractic College West headed by Charles (Skip) Lantz,DC,PhD, has developed what it calls a "comprehensive clinical protocol for determining cervical range of motion."
The research team's findings have been published in Spine (1999; 24(11):1082-1089). Their work started seven years ago when they acquired a sophisticated spinal range-of-motion device from Orthopedic Systems Inc., called the CA-6000 Spinal Motion Analyzer (often referred to as an electrogoniometer). Jiri Dvorak had already published an article (Spine 1992; 17(Suppl):S393-8) on age and gender-related cervical ROM using the same equipment.
"We tried for the next four years to duplicate his findings without success," recalls Dr. Lantz. Those results were presented in Tokyo in 1997 at the WFC conference. Dr. Dvorak was in attendance, was impressed with the team's work, and invited Dr. Lantz to Zurich to resolve the discrepancies.
Dr. Lantz traveled to Zurich in September 1997. After several months of correspondence and planning, an experiment was completed that resolved the differences in observed values for cervical ROM. "As a result of this collaborative study," notes Dr. Lantz, "Dvorak's group utilizes the protocols we developed and which are reported in the Spine article."
Dr. Lantz presented the results of that research at the Eurospine Conference in Innsbruck, Austria in June 1998. This was apparently the first time a chiropractor had presented a paper at the conference. The manuscript for that study is in the final stages of editing and will soon be submitted for publication.
A second article from the Life West group appeared in the most recent issue of Spine (24(15)) and represents a meta-analysis of normal cervical ROM studies. Jasper Chen,DC, who is in the MD/MPH program at Oregon State Health Sciences University, was first author on this project and was an important part of the ROM research conducted by the Lantz group.
"We wanted to do a thorough review of the literature on normal cervical ROM so the results of our findings and the discrepancies with Dvorak's study could be put in proper perspective," explains Dr. Lantz. "Almost from the beginning, we realized that this would have to be a stand-alone paper because the issues were just too complex to stuff into an introduction to an experimental study. I don't know of any other meta-analyses that deal exclusively with normative studies." Early reviews of the manuscript challenged the authors regarding whether the report qualified as a meta-analysis.
The Life West group believes that their collective body of work places them in a leadership role for cervical ROM studies.
"We are offering a reliable and valid procedure for measuring spinal ROM acknowledged by peer review," explained Dr. Lantz.
He added that the Life West studies "assume even greater significance
when seen in light of the recent report (DC 17(11):1) which found
that the AMA guidelines for spinal ROM show little evidence of reliability."
Dr. Lantz judges their spinal ROM measurements as "filling the vacuum
left by the findings that the AMA guidelines promote unreliable procedures."
He also judges his team's work as the standard for all professions that
conduct ROM studies.