Manipulation of Atlanto-Occipital Joint Dysfunction in Addition to Other Regions Improves Neck Proprioception and Mobility: An Observational Repeated Measures Study

To determine whether individuals with occipito-atlantal dysfunction exhibit altered neck proprioception and mobility, and whether this improves following 2 – 6 weeks of spinal manipulation compared with a two-week control period.

25 individuals with occipito-atlantal dysfunction attended three data collection sessions (baseline, control session 2 weeks later, and post-intervention) at a private chiropractic clinic. At each collection a cervical range of motion (ROM) device measured: 2 trials of active neck flexion, extension, lateral flexion and rotation); 3 trials per side for head repositioning accuracy with eyes closed, for Head to neutral and Head to Targets. Intervention: spinal manipulation of atlanto-occipital joint dysfunction followed by other regions over 2-6 weeks (number of treatments dependent on chronicity and severity of presenting problems). ROM and repositioning errors (absolute, constant and variable error) were compared via repeated measures ANOVAs with pre-planned contrasts to baseline.

Deficits in neck proprioception and mobility observed at baseline, with no changes between the baseline and control session (p > 0.05). When comparing post intervention to baseline, neck extension, lateral flexion, and rotation significantly improved (all p < 0.001, ƞp2 > 0.14), and cervical kinesthesia significantly improved, where absolute error decreased in all repositioning tests, variable error decreased for head to neutral, and constant error decreased for both head to target tests (all p < 0.05, ƞp2 > 0.14).

Spinal manipulation focusing on atlanto-occipital joint dysfunction appears to improve neck proprioception and ROM.