Subjective and Objective Assessment of the Preferred Rotational Cervical Spine Position in Infants with an Upper Cervical Spine Dysfunction: A Cross-Sectional Study.

Background: We aimed to assess (1) the awareness of parents regarding the cervical rotation preference of their infant and the agreement of the parent, clinician and objective assessments, and (2) the test-retest reliability for objective (measured) rotation, lateral flexion and combined flexion-rotation.

Methods: This was a cross-sectional study including 69 infants aged three to six months with upper cervical spine dysfunction, without general health issues or specific cervical spine impairments. No treatment was applied. The primary outcomes were parent and clinician assessments of cervical spine rotation preference. The secondary outcome was the cervical range of motion measured by inertial measurement units (IMUs) at two different timepoints. Spearman correlation was performed for the parent, clinician and objective assessments. IMU data were dichotomized into the preferred and unpreferred sides, and test-retest reliability was assessed (ICC).

Results: The mean age of infants was 145 days ± 29.1 days, birth length 49.40 cm ± 2.7 cm, birth weight 3328 g ± 530.9 g and 24 were female. In total, 33 infants were assessed by their parents as right-preferred, 30 as left-preferred and 6 as having no preference. The clinician assessed 38 infants as right-preferred and 31 as left-preferred. The correlation between parents and the clinician was r = 0.687 ( < 0.001), the clinician and the IMU r = 0.408 ( = 0.005) and parents and the IMU r = 0.301 ( = 0.044). The ICC of cervical range of motion measurements ranged from poor to moderate.

Conclusions: Clinicians can use the parents' assessment of cervical spine rotation preference as a foundation for their clinical examination. IMU measurements are difficult in infants, possibly due to their lack of cooperation during measurements.

Clinical Trial Registration Number: clinicaltrails.gov (NCT04981782).