Normal cervical spine range of motion in children 3-12 years old

Study Design. This study measured active cervical spine range of motion ( ROM) in children ages 3-12 years using 2 methodologies: ( 1) a cervical spine ROM instrument, and ( 2) a digital videography based technique. Objective. To determine the active cervical spine ROM, as defined by flexion/extension, lateral bending, and horizontal rotation, for children ages 3-12 years. Summary of Background Data. Review of current literature reveals limited studies of cervical spine ROM in children, many of which do not provide data on children younger than 8 years of age when many of the structural changes of the cervical spine are thought to occur. Methods. A total of 67 children (39 girls) within 3 age groups, 3-5 years (26 children), 6-8 years (22), and 9-12 years (19), were tested in flexion/extension, lateral bending, and horizontal rotation. The subjects repeated the neck movements 3 times for each direction in each method (ROM instrument and videography), and the maximum ROM values were recorded. Within each age group, the mean, standard deviation, and range for each ROM was calculated, and ROM values from the 2 methods were compared. The effect of age and gender on ROM was assessed via analysis of variance. Results. For the ROM instrument, only flexion and right and left rotation were shown to increase with age (P < 0.05). This difference resulted in an increase in ROM of approximately 7 between the youngest and oldest age group. No age effects were present in the videography data. No significant differences between the genders were detected for any of the ROM measures using either method (minimum P = 0.22). In general, the videography method resulted in higher values for flexion, extension, and rotation, and lower values for lateral bending. These differences were greater for the younger children. Conclusions. This study contributes valuable normative data for pediatric cervical spine ROM in children that can be used as a clinical reference and for biomechanical applications. In children 3-12 years of age, both flexion and rotation increased slightly with age. Of interest, there were no differences in ROM with gender, which contradicts adult literature where females have been shown to have more cervical spine ROM than males.