Comparisons of cervical and thoracic spine kinematic joint and body segment angles, timing, and velocity between individuals with and without chronic idiopathic neck pain during functional tasks

Abstract

BackgroundFew studies comprehensively analyse 3D neck kinematics in individuals with chronic idiopathic neck pain during functional tasks considered challenging. This critical knowledge is needed to assist clinicians to recognise and address how altered movement strategies might contribute to pain. Research questionAre there differences in 3D neck kinematics (angles, timing, velocity) during functional tasks in people with chronic neck pain compared to matched asymptomatic control participants? MethodsParticipants with chronic idiopathic neck pain (n = 33) and matched asymptomatic controls (n = 30) performed four functional tasks (overhead reach forward, right and left, and putting on a seatbelt) while evaluated using 3D motion capture. Kinematic variables included joint angles, range of motion (ROM,°), velocity (m s−1) and timing (% of movement phase) for joint angles (head-neck [HN joint], head+neck-upper trunk [HNT], and thoracolumbar) and segments (head, neck, head+neck [HN segment], upper trunk, and trunk. Generalised linear mixed models examined between-group differences. ResultsThere were few between-group differences. The neck pain group had less HN segment extension that controls (mean difference [MD] left −2.06°; 95% CI −3.82, −0.29; p = .023; and right reach −2.52°; −4.67, −0.37; P = .022), and had less total sagittal HNT ROM across all tasks (−1.28; 95% CI −2.25, −0.31; p = .010). Approaching significance was the pain group having less thoracolumbar left rotation than controls (MD −2.14, 95% CI −4.41 to 0.13, p = .064). The pain group had higher neck segment peak flexion velocity than controls across all tasks (MD −3.09; 95% CI −5.21 to −0.10; P = .004). Timing of joint angle peaks did not differ between groups. SignificanceWhen performing an overhead reach task to the left and right and putting on a seatbelt, people with neck pain maintain a more flexed HN segment, use less sagittal ROM and have higher velocity peaks. These findings can assist clinicians in their assessment of patients by identifying possible underlying contributors to neck pain.