Do neck kinematics correlate with pain intensity, neck disability or with fear of motion?

Bahat, Hilla; Weiss, Patrice L.; Sprecher, Elliot; Krasovsky, Andrei; Laufer, Yocheved

doi:10.1016/j.math.2013.10.006

Cited by 80 publications

(45 citation statements)

References 43 publications

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“…Nansel et al showed that a single manipulation could reduce asymmetry of passive regional cervical spine motion [[11]], while Cassidy et al and Martinez-Segura et al independently found that manipulation was associated with both reduced neck pain and increased regional range of neck motion immediately after treatment [[12],[13]]. However, regional neck range of motion is also influenced by pain, disability and fear of movement [[14]], leaving the role of manipulation ambiguous. Furthermore, spinal manipulation targets specific levels, often to improve inter-vertebral range of motion (IV-RoM) [[15]], but it is not known if this actually happens, or if reduced IV-RoM is even detectable by clinical examination (palpation).…”

Section: Introductionmentioning

confidence: 99%

Does inter-vertebral range of motion increase after spinal manipulation? A prospective cohort study

Branney

Breen

2014

Chiropr Man Therap

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BackgroundSpinal manipulation for nonspecific neck pain is thought to work in part by improving inter-vertebral range of motion (IV-RoM), but it is difficult to measure this or determine whether it is related to clinical outcomes.ObjectivesThis study undertook to determine whether cervical spine flexion and extension IV-RoM increases after a course of spinal manipulation, to explore relationships between any IV-RoM increases and clinical outcomes and to compare palpation with objective measurement in the detection of hypo-mobile segments.MethodThirty patients with nonspecific neck pain and 30 healthy controls matched for age and gender received quantitative fluoroscopy (QF) screenings to measure flexion and extension IV-RoM (C1-C6) at baseline and 4-week follow-up between September 2012-13. Patients received up to 12 neck manipulations and completed NRS, NDI and Euroqol 5D-5L at baseline, plus PGIC and satisfaction questionnaires at follow-up. IV-RoM accuracy, repeatability and hypo-mobility cut-offs were determined. Minimal detectable changes (MDC) over 4 weeks were calculated from controls. Patients and control IV-RoMs were compared at baseline as well as changes in patients over 4 weeks. Correlations between outcomes and the number of manipulations received and the agreement (Kappa) between palpated and QF-detected of hypo-mobile segments were calculated.ResultsQF had high accuracy (worst RMS error 0.5o) and repeatability (highest SEM 1.1o, lowest ICC 0.90) for IV-RoM measurement. Hypo-mobility cut offs ranged from 0.8o to 3.5o. No outcome was significantly correlated with increased IV-RoM above MDC and there was no significant difference between the number of hypo-mobile segments in patients and controls at baseline or significant increases in IV-RoMs in patients. However, there was a modest and significant correlation between the number of manipulations received and the number of levels and directions whose IV-RoM increased beyond MDC (Rho=0.39, p=0.043). There was also no agreement between palpation and QF in identifying hypo-mobile segments (Kappa 0.04-0.06).ConclusionsThis study found no differences in cervical sagittal IV-RoM between patients with non-specific neck pain and matched controls. There was a modest dose-response relationship between the number of manipulations given and number of levels increasing IV-RoM - providing evidence that neck manipulation has a mechanical effect at segmental levels. However, patient-reported outcomes were not related to this.

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Section: Introductionmentioning

confidence: 99%

Does inter-vertebral range of motion increase after spinal manipulation? A prospective cohort study

Branney

Breen

2014

Chiropr Man Therap

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“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] It appears that VR may change how the brain physically registers pain, not just the perception of pain stimuli. 2 An interesting study showed that 86% of patients undergoing wound care from a burn injury reported severe to excruciating pain even with therapeutic levels of opioids.…”

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confidence: 99%

“…Moreover, VR was seen to not only reduce pain but objectively increase function. 16 A pilot study of VR to treat fibromyalgia in 2013 studied the long-term effects of VR therapy. The six women in the study who had undergone 10 sessions of therapy supported by adaptive virtual environments (VEs) were assessed at pretreatment, post-treatment, and at 6 months follow-up.…”

mentioning

confidence: 99%

Virtual Reality as a Distraction Technique in Chronic Pain Patients

Wiederhold

Gao²,

Sulea³

et al. 2014

Cyberpsychology, Behavior, and Social Networking

167

112

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We explored the use of virtual reality distraction techniques for use as adjunctive therapy to treat chronic pain. Virtual environments were specifically created to provide pleasant and engaging experiences where patients navigated on their own through rich and varied simulated worlds. Real-time physiological monitoring was used as a guide to determine the effectiveness and sustainability of this intervention. Human factors studies showed that virtual navigation is a safe and effective method for use with chronic pain patients. Chronic pain patients demonstrated significant relief in subjective ratings of pain that corresponded to objective measurements in peripheral, noninvasive physiological measures.

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“…Pearson's correlation coefficients between −0.16 and −0.58 have been reported for ROM or peak velocity against VAS (Kasch et al, 2001;Sarig Bahat et al, 2014) or NPQ (Chiu et al, 2005;Howell et al, 2012), which is less than the correlation obtained with . Multiple correlation coefficients and mean absolute error of the models.…”

Section: Comparison With Previous Studiesmentioning

confidence: 73%

“…However, only a few papers have studied the relationship between neck kinematics and clinical scales, reporting poor to moderate correlations. Most of them focus on chronic neck pain, comparing clinical scales with cervical ROM, either measured in conventional tests (Howell et al, 2012;Ylinen et al, 2004), or with virtual reality games that allowed velocities and other kinematic parameters to be measured (Sarig Bahat et al, 2014;Treleaven et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Relationship between neck motion and self-reported pain in patients with whiplash associated disorders during the acute phase

Rosario

Vivas

Sinovas

et al. 2018

Musculoskeletal Science and Practice

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Background: Biomechanical measures quantify motor control and functional deficits in Whiplash Associated Disorders (WAD), but few studies relate those measures to the clinical scales that are routinely used to assess patients. Most studies are limited to chronic neck pain, and report poor to moderate correlations. Objective: To define a statistical model that relates measures of neck kinematics with clinical scales of neck pain, in WAD patients during the rehabilitation process in the acute phase (less than 3 months since the accident). Methods: 96 WAD patients self-assessed their pain using VAS and NPQ, and passed neck motion tests as part of their rehabilitation program. Four regression models were fitted to analyze the effects of the measured kinematic parameters and subject-specific characteristics on VAS and NPQ. Model errors were compared to minimal clinically significant differences. Results: Multiple correlation coefficients of the models were between 0.74 and 0.90. More than 66% of that correlation was accounted for by subject-specific factors, and most of the other half by the measured kinematic parameters. Range of motion of flexion-extension and axial rotation, and harmonicity of flexion-extension, where the variables most consistently related to the decrease of pain. The error of the models was within the MCSD in more than 50% of the observations. Conclusions: Part of the individual progression of pain and pain-related disability in acute WAD patients, as rated by NPQ and VAS, can be mapped to objective kinematic parameters of neck mobility tests, like ranges of motion, velocities, repeatability and harmonicity of movements.

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Do neck kinematics correlate with pain intensity, neck disability or with fear of motion?

Cited by 80 publications

References 43 publications

Does inter-vertebral range of motion increase after spinal manipulation? A prospective cohort study

Does inter-vertebral range of motion increase after spinal manipulation? A prospective cohort study

Virtual Reality as a Distraction Technique in Chronic Pain Patients

Relationship between neck motion and self-reported pain in patients with whiplash associated disorders during the acute phase

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