Download Reliability of Goniometer

Headache Clinics UK
Using a Goniometer
Lynn Wilkes
Cervical Range of Motion
Cervical Range of Motion
Reliability of Goniometer
A range of studies have confirmed the goniometer,
including the basic plastic one, is a valid and
reliable measurement instrument for cervical spine
range of motion
Cervical Range of Motion
Flexion and extension (A and B)
the goniometer axis was positioned at the
level of the seventh cervical vertebra,
the fixed arm was kept parallel to the floor
and,
at the end of the movement, the moving
arm was aligned with the earlobe
Cervical Range of Motion
Rotation (C): the goniometer axis was
positioned at the centre of the head,
the fixed arm was positioned at the centre
of the head, at the sagittal suture,
at the end of the movement, the moving arm
was aligned with the nose;
Cervical Range of Motion
Lateral flexion (D): the goniometer
axis was placed on the spinous
process of the seventh cervical
vertebra,
the fixed arm was placed parallel to
the floor and the moving arm was
aligned with the midline of the cervical
spine;
Headache Clinics UK
Trigger Point Therapy For
Headaches
Trigger Points
Travell defined a TrP as “a hyperirritable spot in skeletal
muscle that is associated with a hypersensitive palpable
nodule in a taut band. The spot is tender when pressed and
can give rise to characteristic referred pain, motor dysfunction,
and autonomic phenomena.”.
Trigger Points
Research
Travell Trigger Points—Molecular and Osteopathic Perspectives
John M. McPartland, DO, MS
Myofascial trigger points and sensitization: an updated pain
model for tension-type headache
C Fernández-de-las-Peñas1,2, ML Cuadrado2,3,
CHIROPRACTIC MANAGEMENT OF MYOFASCIAL TRIGGER POINTS AND
MYOFASCIAL PAIN SYNDROME: A SYSTEMATIC REVIEW OF THE
LITERATURE
Howard Vernon, DC, PhD,a and Michael Schneider, DCb
Myofascial trigger points in the suboccipital muscles in episodic
tension - type headache
Cesar Fernandez-de-las-Penasa,
Contribution of Myofascial Trigger Points to Migraine Symptoms
Maria Adele Giamberardino, Emmanuele Tafuri,
Key Muscles in
Headaches
Key Muscles in
Headaches
Trapezius
Sub Occipital
Sternocleidomastoid
Splenius capitis
Frontalis
Splenius cervicus
Medial Ptyergoid
Rectus capitis posterior minor
Lateral Ptyergoid
Rectus capitis posterior major
Masseter
Semispinalis capitis
Temporalis
Semi spinalis cervicis
Referral Patterns
TRAPEZIUS
Referral Patterns
STERNOCLEIDOMASTOID
Referral Patterns
Diagastric
Occipital Frontalis
Temporalis
Referral Patterns
Sub Occipital
Rectus capitis posterior minor
Rectus capitis posterior major
Semispinalis cervicus
Semi spinalis capitis
Referral Patterns
Sub Occipital
Splenius capitis
Splenius cervicus
TMJ Research Leads to Discovery
In addition to a new muscle of mastication, he
also discovered a connective tissue bridge that
attaches the rectus capitus posterior minor
muscle to the dura at the atlanto – occipital
junction. (it was present in all 10 cadavers)
Hack GD. Anatomic relation between the rectus
capitus posterior minor muscle and the dura matter.
Spine 1995: 20:2484-2486
The Neuromuscular Connection
• Dr. Hack stated:
– Maryland Scientists speculate that the newly
described muscle – dura connection may
transmit forces from the neck muscles to the
pain sensitive dura.
Stained Slide
Dura
The
Connection
Atlas
Occiput
Rectus
Capitus
Posterior
Minor
Occiput
Dura
Rectus Capitus
Posterior
(RCPM)
Muscle
Connective
Tissue
C1 Transverse Process
Referral Patterns
Lateral Pterygoid
Trigger Point Therapy
Practical
Mary Sanderson