{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:45Z","timestamp":1787028645346,"version":"build-2736575974"},"reference-count":49,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005632","name":"National Centre for Research and Development","doi-asserted-by":"publisher","award":["POIR.04.01.04-00-0113\/19"],"award-info":[{"award-number":["POIR.04.01.04-00-0113\/19"]}],"id":[{"id":"10.13039\/501100005632","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005632","name":"National Centre for Research and Development","doi-asserted-by":"publisher","award":["503\/6-127-02\/503-61-001"],"award-info":[{"award-number":["503\/6-127-02\/503-61-001"]}],"id":[{"id":"10.13039\/501100005632","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medical University of Lodz, Poland","award":["POIR.04.01.04-00-0113\/19"],"award-info":[{"award-number":["POIR.04.01.04-00-0113\/19"]}]},{"name":"Medical University of Lodz, Poland","award":["503\/6-127-02\/503-61-001"],"award-info":[{"award-number":["503\/6-127-02\/503-61-001"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Cervical spine disorders (CSDs) are a common cause of neck pain. Proper diagnosis is of great importance in planning the management of a patient with neck pain. Hence, the aim of this study is to provide an overview of the clinical pattern of early-stage functional disorders affecting the cervical and cervico-thoracic regions of the spine, considering the age and sex of the subjects. Methods: Two hundred adult volunteers were included in the study. Manual examination of segments C0\/C1-Th3\/Th4 was performed according to the methodology of the Katenborn\u2013Evjenth manual therapy concept and the spine curvatures were assessed (cervical lordosis and thoracic kyphosis). Results: The most common restricted movement was lateral flexion to the left, and the least disturbed movement were observed in the sagittal plane (flexion and extension). The most affected segment was C7\/Th1 (71.5% participants had problems in this segment), and the least affected segment was Th3\/Th4 (69.5% participants had no mobility disorders in this segment). The number of disturbed segments did not differ between men and women (p &gt; 0.05), but increased with age (r = 0.14, p = 0.04). Conclusions: Cervical mobility in adult population is frequently restricted. The number of affected segments increased with age and was not sex-dependent.<\/jats:p>","DOI":"10.3390\/jcm13030840","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T09:43:22Z","timestamp":1706780602000},"page":"840","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Analysis of Clinical Pattern of Musculoskeletal Disorders in the Cervical and Cervico\u2014Thoracic Regions of the Spine"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5522-6128","authenticated-orcid":false,"given":"Gabriela","family":"Figas","sequence":"first","affiliation":[{"name":"Clinic of Medical Rehabilitation, Medical University of Lodz, 92-213 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6256-1669","authenticated-orcid":false,"given":"Joanna","family":"Kostka","sequence":"additional","affiliation":[{"name":"Department of Gerontology, Medical University of Lodz, 93-113 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4426-4908","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Pikala","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Medical University of Lodz, 90-752 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta Ewa","family":"Kujawa","sequence":"additional","affiliation":[{"name":"Clinic of Medical Rehabilitation, Medical University of Lodz, 92-213 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8957-2368","authenticated-orcid":false,"given":"Tomasz","family":"Adamczewski","sequence":"additional","affiliation":[{"name":"Clinic of Medical Rehabilitation, Medical University of Lodz, 92-213 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,1]]},"reference":[{"key":"ref_1","first-page":"150","article-title":"Neck Pain: Initial Evaluation and Management","volume":"102","author":"Childress","year":"2020","journal-title":"Am. Fam. Physician"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.mcna.2019.11.003","article-title":"Neck Pain and Lower Back Pain","volume":"104","author":"Popescu","year":"2020","journal-title":"Med. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"75","DOI":"10.2217\/pmt-2020-0046","article-title":"The contemporary management of neck pain in adults","volume":"11","author":"Fandim","year":"2021","journal-title":"Pain Manag."},{"key":"ref_4","first-page":"180","article-title":"Chronic Neck Pain: Nonpharmacologic Treatment","volume":"100","author":"Barreto","year":"2019","journal-title":"Am. Fam. Physician"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Kazeminasab, S., Nejadghaderi, S.A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman MJ, M., Kolahi, A.A., and Safiri, S. (2022). Neck pain: Global epidemiology, trends and risk factors. BMC Musculoskelet. Disord., 23.","DOI":"10.1186\/s12891-021-04957-4"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1179\/jmt.2008.16.3.155","article-title":"Predictor Variables for a Positive Long-Term Functional Outcome in Patients with Acute and Chronic Neck and Back Pain Treated with a McKenzie Approach: A Secondary Analysis","volume":"16","author":"May","year":"2008","journal-title":"J. Man. Manip. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/2045-709X-20-27","article-title":"Predictors of outcome in neck pain patients undergoing chiropractic care: Comparison of acute and chronic patients","volume":"20","author":"Peterson","year":"2012","journal-title":"Chiropr. Man. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1007\/s12178-019-09594-y","article-title":"The Relationship Between Forward Head Posture and Neck Pain: A Systematic Review and Meta-Analysis","volume":"12","author":"Mahmoud","year":"2019","journal-title":"Curr. Rev. Musculoskelet. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1007\/s00586-020-06640-z","article-title":"Neck pain associated with smartphone overuse: Cross-sectional report of a cohort study among office workers","volume":"30","author":"Derakhshanrad","year":"2021","journal-title":"Eur. Spine J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"43","DOI":"10.61186\/ijmcl.5.3.43","article-title":"Investigating the Effect of Simultaneous Dual Task Execution on the Balance Position of People with Forward Head Posture","volume":"5","author":"Minoonejad","year":"2023","journal-title":"Int. J. Mot. Control Learn."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2021","DOI":"10.1007\/s10072-021-05491-w","article-title":"Instrumental assessment of physiotherapy and onabolulinumtoxin-A on cervical and headache parameters in chronic migraine","volume":"43","author":"Deodato","year":"2022","journal-title":"Neurol Sci."},{"key":"ref_12","unstructured":"Kaltenborn, F.M., and Evjenth, O. (1989). Manual Mobilization of the Extremity Joints, Orthopedic Physical Therapy Products."},{"key":"ref_13","first-page":"1","article-title":"The Maitland Concept: Assessment, examination and treatment of movement impairments by passive movement","volume":"1","author":"Maitland","year":"2013","journal-title":"Maitland\u2019s Vertebr. Manip. Manag. Neuromusculoskel. Disord."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.2519\/jospt.2017.0302","article-title":"Neck Pain: Revision 2017","volume":"47","author":"Blanpied","year":"2017","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_15","unstructured":"Banks, K., and Hengeveld, E. (2013). Terapia Manualna Wed\u0142ug Maitlanda, Elsevier. [1st ed.]."},{"key":"ref_16","unstructured":"Westerhuis, P., and Wiesner, R. (2015). Clinical Patterns in Manual Therapy, Georg Thieme Publishing Company. [2nd ed.]."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1002\/ejp.1679","article-title":"Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines","volume":"25","author":"Corp","year":"2021","journal-title":"Eur. J. Pain"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/BRS.0b013e3181644641","article-title":"Clinical practice implications of the Bone and Joint Decade 2000\ud840\ude132010 Task Force on Neck Pain and Its Associated Disorders: From concepts and findings to recommendations","volume":"33","author":"Guzman","year":"2008","journal-title":"Spine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"167","DOI":"10.2340\/165019771997167174","article-title":"Reduced mobility in the cervico-thoracic motion segment--a risk factor for musculoskeletal neck-shoulder pain: A two-year prospective follow-up study","volume":"29","author":"Norlander","year":"1997","journal-title":"Scand. J. Rehabil. Med."},{"key":"ref_20","unstructured":"Kaltenborn, F.M. (1998). Kr\u0119gos\u0142up\u2014Badanie Manualne i Mobilizacja, Rolewski Nowa Wie\u015b. [1st ed.]."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.jpain.2018.07.009","article-title":"Measurement Properties of Visual Analogue Scale, Numeric Rating Scale, and Pain Severity Subscale of the Brief Pain Inventory in Patients with Low Back Pain: A Systematic Review","volume":"20","author":"Chiarotto","year":"2019","journal-title":"J. Pain"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1002\/acr.20543","article-title":"Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)","volume":"63","author":"Hawker","year":"2011","journal-title":"Arthritis Care Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/S1836-9553(12)70077-2","article-title":"Pain intensity ratings","volume":"58","author":"Kamper","year":"2012","journal-title":"J. Physiother."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Zwoli\u0144ska, J., Weres, A., and Wyszy\u0144ska, J. (2018). One-Year Follow-Up of Spa Treatment in Older Patients with Osteoarthritis: A Prospective, Single Group Study. BioMed. Res. Int., 2018.","DOI":"10.1155\/2018\/7492106"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"771","DOI":"10.13075\/mp.5893.00121","article-title":"Back and neck pain among school teachers in Poland and its correlations with physical activity","volume":"66","author":"Rottermund","year":"2015","journal-title":"Med. Pr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1097\/BRS.0000000000002796","article-title":"Comparison of Patient Reported Outcome Measurement Information System with Neck Disability Index and Visual Analog Scale in Patients with Neck Pain","volume":"44","author":"Moses","year":"2019","journal-title":"Spine"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Cramer, H., Lauche, R., Langhorst, J., Dobos, G.J., and Michalsen, A. (2014). Validation of the German version of the Neck Disability Index (NDI). BMC Musculoskelet. Disord., 15.","DOI":"10.1186\/1471-2474-15-91"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"m791","DOI":"10.1136\/bmj.m791","article-title":"Global, regional, and national burden of neck pain in the general population, 1990-2017: Systematic analysis of the Global Burden of Disease Study 2017","volume":"368","author":"Safiri","year":"2020","journal-title":"BMJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1590\/S1807-59322008000600010","article-title":"Effect of global posture reeducation and of static stretching on pain, range of motion, and quality of life in women with chronic neck pain: A randomized clinical trial","volume":"63","author":"Cunha","year":"2008","journal-title":"Clinics"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/S0161-4754(99)70002-3","article-title":"Interexaminer reliability in physical examination of the cervical spine","volume":"22","author":"Fjellner","year":"1999","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1007\/s00586-004-0713-5","article-title":"Intervertebral mobility in the progressive degenerative process. A radiostereometric analysis","volume":"13","author":"Axelsson","year":"2004","journal-title":"Eur. Spine J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s40122-020-00230-z","article-title":"Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review","volume":"10","author":"Peng","year":"2021","journal-title":"Pain Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.ejpain.2003.11.005","article-title":"Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain","volume":"8","author":"Ylinen","year":"2004","journal-title":"Eur. J. Pain"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1589\/jpts.25.865","article-title":"The effects of thoracic manipulation versus mobilization for chronic neck pain: A randomized controlled trial pilot study","volume":"25","author":"Suvarnnato","year":"2013","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jcm.2019.10.004","article-title":"Smartphone Applications as a Suitable Alternative to CROM Device and Inclinometers in Assessing the Cervical Range of Motion in Patients with Nonspecific Neck Pain","volume":"19","author":"Ghorbani","year":"2020","journal-title":"J. Chiropr. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"728","DOI":"10.2466\/pms.2003.96.3.728","article-title":"Grip strength: A summary of studies comparing dominant and nondominant limb measurements","volume":"96","author":"Bohannon","year":"2003","journal-title":"Percept. Mot. Ski."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s12998-020-00327-4","article-title":"Immediate effects of cervicothoracic junction mobilization versus thoracic manipulation on the range of motion and pain in mechanical neck pain with cervicothoracic junction dysfunction: A pilot randomized controlled trial","volume":"28","author":"Joshi","year":"2020","journal-title":"Chiropr. Man. Ther."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1136\/jech.2009.090720","article-title":"Risk factors for the onset of non-specific neck pain: A systematic review","volume":"64","author":"McLean","year":"2010","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1093\/pm\/pnaa368","article-title":"Female Gender Is Associated with a Higher Prevalence of Chronic Neck Pain, Chronic Low Back Pain, and Migraine: Results of the Spanish National Health Survey, 2017","volume":"22","year":"2021","journal-title":"Pain Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e273","DOI":"10.1016\/j.bja.2019.03.023","article-title":"Chronic pain: A review of its epidemiology and associated factors in population-based studies","volume":"123","author":"Nicolson","year":"2019","journal-title":"Br. J. Anaesth."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.jad.2007.06.005","article-title":"Risk factors for anxiety and depression in the elderly: A review","volume":"106","author":"Vink","year":"2008","journal-title":"J. Affect. Disord."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.jad.2019.08.089","article-title":"The comorbidity of mental and physical disorders with self-reported chronic back or neck pain: Results from the China Mental Health Survey","volume":"260","author":"Xu","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.pmr.2017.06.004","article-title":"Physiologic Changes of the Musculoskeletal System with Aging: A Brief Review","volume":"28","author":"Frontera","year":"2017","journal-title":"Phys. Med. Rehabil. Clin. N. Am."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"8515","DOI":"10.1038\/s41598-019-44837-5","article-title":"Relationship between age, BMI, head posture and superficial neck muscle stiffness and elasticity in adult women","volume":"9","author":"Kocur","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.spinee.2005.12.010","article-title":"Neurological and functional outcome after unstable cervicothoracic junction injury treated by posterior reduction and synthesis","volume":"6","author":"Lenoir","year":"2006","journal-title":"Spine J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1097\/00007632-199707010-00009","article-title":"Radiographic standing cervical segmental alignment in adult volunteers without neck symptoms","volume":"22","author":"Hardacker","year":"1997","journal-title":"Spine"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1007\/s00586-006-0254-1","article-title":"The association between cervical spine curvature and neck pain","volume":"16","author":"Grob","year":"2007","journal-title":"Eur. Spine J."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s12998-021-00377-2","article-title":"Inter-examinerreliability study of physical examination procedures to assess the cervical spine","volume":"29","author":"Hariharan","year":"2021","journal-title":"Chiropr. Man. Ther."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S1356-689X(03)00017-1","article-title":"Reproducibility and repeatability: Errors of three groups of physiotherapists in locating spinal levels by palpation","volume":"8","author":"Billis","year":"2003","journal-title":"Man. Ther."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/3\/840\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:52:55Z","timestamp":1760104375000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/3\/840"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,1]]},"references-count":49,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["jcm13030840"],"URL":"https:\/\/doi.org\/10.3390\/jcm13030840","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,1]]}}}