View source for PPIVMs of the Cervical Spine - Assessment

== Introduction ==
Passive assessment of segmental movements includes Passive Physiological Intervertebral Movements (PPIVMs) and

Assessment of passive intervertebral movements form an important part of the physical assessment of people with musculoskeletal spinal conditions and serves to localize and characterize impairments of mobility of individual motion segments. Assessment of passive intervertebral movements can be divided into Passive Physiological Intervertebral movements (PPIVMs) and [[PAIVMs of the Cervical Spine - Assessment|Passive Accessory Intervertebral Movements]] (PAIVMs). Although these terms originated with the [[Maitland's Mobilisations|Maitland approach]], they can be used to describe assessment techniques used in a variety of approaches.

There is some contention about whether limitations of segmental mobility actually exist and, if they do, whether their assessment is relevant. At least in the cervical spine, specifically targeted treatment produces superior results to general treatment.<ref>Slaven EJ, Goode AP, Coronado RA, Poole C, Hegedus EJ. The relative effectiveness of segment specific level and non-specific level spinal joint mobilization on pain and range of motion: results of a systematic review and meta-analysis. Journal of Manual & Manipulative Therapy (Maney Publishing). 2013;21(1):7-17.</ref> In order to specifically target treatment, it is necessary to localize impairments of individual motion segments by assessing their mobility.

PPIVMs are defined as passively producing movements in directions that can be performed actively. Like active movements, PPIVMs usually involve rotation around at least one axis

PAIVMs are defined as producing movements in directions that can not be produced actively in isolation but nonetheless need to be available for active movements to occur. In the periphery, these movements are generally glides produced by a linear force and result in translational rather than rotational movement. In the spine, PAIVMs are produced by applying a translational force, but unlike in the periphery, the movements that are produced are not [[PAIVMs of the Cervical Spine - Assessment|purely translational]].

This section will primarily consider two axes of PPIVMS of the cervical spine which will be referred to as rotation and lateral flexion.