title: Neck pain assessment in a virtual environment.
abstract: METHODS
  Neck-pain and control group comparative analysis of conventional and virtual reality (VR)-based assessment of cervical range of motion (CROM).
  
  
  OBJECTIVE
  To use a tracker-based VR system to compare CROM of individuals suffering from chronic neck pain with CROM of asymptomatic individuals; to compare VR system results with those obtained during conventional assessment; to present the diagnostic value of CROM measures obtained by both assessments; and to demonstrate the effect of a single VR session on CROM.
  
  
  BACKGROUND
  Neck pain is a common musculoskeletal complaint with a reported annual prevalence of 30% to 50%. In the absence of a gold standard for CROM assessment, a variety of assessment devices and methodologies exist. Common to these methodologies, assessment of CROM is carried out by instructing subjects to move their head as far as possible. However, these elicited movements do not necessarily replicate functional movements which occur spontaneously in response to multiple stimuli. To achieve a more functional approach to cervical motion assessment, we have recently developed a VR environment in which electromagnetic tracking is used to monitor cervical motion while participants are involved in a simple yet engaging gaming scenario.
  
  
  METHODS
  CROM measures were collected from 25 symptomatic and 42 asymptomatic individuals using VR and conventional assessments. Analysis of variance was used to determine differences between groups and assessment methods. Logistic regression analysis, using a single predictor, compared the diagnostic ability of both methods.
  
  
  RESULTS
  Results obtained by both methods demonstrated significant CROM limitations in the symptomatic group. The VR measures showed greater CROM and sensitivity while conventional measures showed greater specificity. A single session exposure to VR resulted in a significant increase in CROM.
  
  
  CONCLUSIONS
  Neck pain is significantly associated with reduced CROM as demonstrated by both VR and conventional assessment methods. The VR method provides assessment of functional CROM and can be used for CROM enhancement. Assessment by VR has greater sensitivity than conventional assessment and can be used for the detection of true symptomatic individuals.
authors.affiliation: Department of Physical Therapy, University of Haifa, Mount Carmel, Haifa, Israel. hbahat@research.haifa.ac.il
authors.forename: Hilla
authors.initials: H
authors.lastname: Sarig-Bahat
authors.forename: Patrice L Tamar
authors.initials: PL
authors.lastname: Weiss
authors.forename: Yocheved
authors.initials: Y
authors.lastname: Laufer
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000503:physiopathology*; D002908:Chronic Disease; D004185:Disability Evaluation; D055590:Electromagnetic Phenomena; D005260:Female; D019416:Head Movements; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis* / Q000503:physiopathology; D010147:Pain Measurement; D011237:Predictive Value of Tests; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D014584:User-Computer Interface; D018910:Video Games; D055815:Young Adult