title: Interactive cervical motion kinematics: sensitivity, specificity and clinically significant values for identifying kinematic impairments in patients with chronic neck pain.
abstract: Chronic 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 (represented by number of velocity peaks (NVP)), symmetry (represented by time to peak velocity percentage (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. Such identification of presence or absence of kinematic impairments may direct treatment strategies and additional evaluation when needed.
authors.affiliation: Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa 31905, Israel; CCRE Spine, Division of Physiotherapy, School of Health and Rehabilitation Science, The University of Queensland, Brisbane 4072, Australia. Electronic address: hbahat@physicalvirtue.co.il.
authors.forename: Hilla
authors.initials: H
authors.lastname: Sarig Bahat
authors.affiliation: CCRE Spine, Division of Physiotherapy, School of Health and Rehabilitation Science, The University of Queensland, Brisbane 4072, Australia.
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa 31905, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Reznik
authors.affiliation: Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa 31905, Israel.
authors.forename: Einat
authors.initials: E
authors.lastname: Kodesh
authors.affiliation: CCRE Spine, Division of Physiotherapy, School of Health and Rehabilitation Science, The University of Queensland, Brisbane 4072, Australia.
authors.forename: Julia
authors.initials: J
authors.lastname: Treleaven
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000503:physiopathology; D059350:Chronic Pain; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis*; D010147:Pain Measurement; D012372:ROC Curve; D016059:Range of Motion, Articular / Q000502:physiology*; D012016:Reference Values; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014584:User-Computer Interface
keywords: Kinematics; Neck pain; Sensitivity; Virtual reality