A new clinical test for cervicocephalic kinesthetic sensibility: “the fly”

Abstract

Kristjansson E, Hardardottir L, Asmundardottir M, Gudmundsson K. A new clinical test for cervicocephalic kinesthetic sensibility: “The Fly.” Arch Phys Med Rehabil 2004;85:490–5. Objective To investigate the reliability and discriminative ability of a new test designed to detect accuracy of neck movements. Design Repeated-measures. Case-control. Setting University musculoskeletal research clinic in Iceland. Participants Twenty women (mean age ± standard deviation [SD], 30.8±9.1y; range, 18–49y) with chronic whiplash-associated disorders (WAD) grades I and II (duration, 6mo–6y), with current pain score on a visual analog scale of 46.8±21.8, and a disability score on the Northwick Park Neck Pain Disability Index of 45%±14%. Twenty asymptomatic women (mean age ± SD, 29.3±8.6y; range, 18–48y) with no history of whiplash or insidious onset neck pain served as controls. Intervention A slowly moving object appeared on a computer screen and traced an unpredictable movement path that the subjects were required to follow by moving their heads. Three randomly ordered movement patterns were tested. Main outcome measure A new software program connected to a 3Space Fastrak system was used to measure the mean absolute error (in millimeters) of 3 trials in each movement pattern. Results The mean differences (±2 SD) between days 1 and 2 were .01±.64mm for the asymptomatic group and .33±1.80mm for the WAD group. The between-day intraclass correlation coefficients were between .60 and .77 for the asymptomatic group and .79 and .86 for the WAD group. Repeated-measures analysis of variance revealed a significant difference between groups ( P=.02). The Tukey post hoc test showed significant between-group differences for each movement pattern ( P≤.05). In each successive trial, a slight improvement for the asymptomatic group and a slight worsening for the WAD group were detected. Conclusions Better reliability was detected for the asymptomatic group than for the WAD group. The test could discriminate between the asymptomatic group versus the chronic WAD group.