Interactive cervical motion kinematics: Sensitivity, specificity and clinically significant values for identifying kinematic impairments in patients with chronic neck pain

Abstract

Interactive cervical motion kinematics: sensitivity, specificity and clinically significant values for identifying kinematic impairments in patients with chronic neck pain. AbstractChronic neck pain has been consistently shown to be associated with impaired kinematic control including reduced range, velocity and smoothness of cervical motion, that seem relevant to daily function as in quick neck motion in response to surrounding stimuli. The objectives of this study were: to compare interactive cervical kinematics in patients with neck pain and controls; to explore the new measures of cervical motion accuracy; and to find the sensitivity, specificity, and optimal cutoff values for defining impaired kinematics in those with neck pain.In this cross-section study, 33 patients with chronic neck pain and 22 asymptomatic controls were assessed for their cervical kinematic control using interactive virtual reality hardware and customized software utilizing a head mounted display with built-in head tracking.Outcome measures included peak and mean velocity, smoothness (NVP), symmetry (TTPP), and accuracy of cervical motion.Results demonstrated significant and strong effect-size differences in peak and mean velocities, NVP and TTPP in all directions excluding TTPP in left rotation, and good effect-size group differences in 5/8 accuracy measures.Regression results emphasized the high clinical value of neck motion velocity, with very high sensitivity and specificity (85%-100%), followed by motion smoothness, symmetry and accuracy. These finding suggest cervical kinematics should be evaluated clinically, and screened by the provided cut off values for identification of relevant impairments in those with neck pain. M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPTSuch identification of presence or absence of kinematic impairments may direct treatment strategies and additional evaluation when needed.

DYSKIMOT: An Ultra-Low-Cost Inertial Sensor to Assess Head’s Rotational Kinematics in Adults during the Didren-Laser Test

“…In our case for example, it is known that patients with neck pain have poorer sensory-motor control with open eyes, characterized by an increase in joint positioning error and a decrease in speed and acceleration during all movements [12]. The absence of difference in our kinematics data between patients and participants could seem unexpected as previous studies showed significant differences in terms of kinematics [5,46]. However this absence of difference could be explained by our sample size, resulted in low power, and by the difficulty for the DidRen laser to discriminate between such groups [47,48].…”

Dizziness, Unsteadiness, Visual Disturbances, and Sensorimotor Control in Traumatic Neck Pain

“…Recently, accuracy in following a moving target in a virtual environment has been shown to be somewhat sensitive and specific to those with neck pain. 4 To date, no specific differences in those with traumatic neck pain compared to INP have been noted, but this is a continued area of investigation (FIGURE 3).…”

A Novel Virtual Reality Technique (Cervigame®) Compared to Conventional Proprioceptive Training to Treat Neck Pain: A Randomized Controlled Trial

“…Neck pain (NP) is a global problem [1], with a reported lifetime prevalence of about 70% in different populations [2,3]. Patients with NP have demonstrated impairment in a wide range of sensorimotor functions [4-7]. The density of mechanoreceptors and muscle spindles in cervical region has increased [8,9], and these elements are associated with vestibular, visual and postural control systems which provide information that is important in regulating postural balance [10,11].…”

“…Despite potential benefits of VR technology in physical rehabilitation [19] and pain reduction [20-24], only a few studies have evaluated the efficacy of this type of treatment in patients with NP [26,27]. Recently, a VR device was developed to assess [7] and treat [26] cervical kinematics in patients with NP. In a pilot study to compare the effects of cervical kinematic training with and without this new VR device, between-group analysis showed improvements in overall perceived change in VR plus kinematic training group but no significant improvement in neck disability, range of motion or dynamic balance [26].…”