Abstract
BackgroundAssessment of sensorimotor function is useful for classification and treatment evaluation of neck pain disorders. Several studies have investigated various aspects of cervical motor functions. Most of these have involved slow or self-paced movements, while few have investigated fast cervical movements. Moreover, the reliability of assessment of fast cervical axial rotation has, to our knowledge, not been evaluated before.MethodsCervical kinematics was assessed during fast axial head rotations in 118 women with chronic nonspecific neck pain (NS) and compared to 49 healthy controls (CON). The relationship between cervical kinematics and symptoms, self-rated functioning and fear of movement was evaluated in the NS group. A sub-sample of 16 NS and 16 CON was re-tested after one week to assess the reliability of kinematic variables. Six cervical kinematic variables were calculated: peak speed, range of movement, conjunct movements and three variables related to the shape of the speed profile.ResultsTogether, peak speed and conjunct movements had a sensitivity of 76% and a specificity of 78% in discriminating between NS and CON, of which the major part could be attributed to peak speed (NS: 226 ± 88 °/s and CON: 348 ± 92 °/s, p < 0.01). Peak speed was slower in NS compared to healthy controls and even slower in NS with comorbidity of low-back pain. Associations were found between reduced peak speed and self-rated difficulties with running, performing head movements, car driving, sleeping and pain. Peak speed showed reasonably high reliability, while the reliability for conjunct movements was poor.ConclusionsPeak speed of fast cervical axial rotations is reduced in people with chronic neck pain, and even further reduced in subjects with concomitant low back pain. Fast cervical rotation test seems to be a reliable and valid tool for assessment of neck pain disorders on group level, while a rather large between subject variation and overlap between groups calls for caution in the interpretation of individual assessments.
Highlights
Assessment of sensorimotor function is useful for classification and treatment evaluation of neck pain disorders
For Peak Speed, range of movement (ROM) and A/D-ratio, ICCs were moderate to high, and coefficient of variation (CV) were lower compared to the other variables, indicating that these were the most reliable variables
A significant difference between the groups was present for standard error of measurement (SEM) of CM, evident by the fact that the confidence interval (CI) did not overlap between the groups
Summary
Assessment of sensorimotor function is useful for classification and treatment evaluation of neck pain disorders. Several studies have investigated various aspects of cervical motor functions Most of these have involved slow or self-paced movements, while few have investigated fast cervical movements. The reliability of assessment of fast cervical axial rotation has, to our knowledge, not been evaluated before. A majority of the studies that characterized cervical movements in people with neck pain have involved slow or self-paced speed tasks. Tests of fast cervical movements may, in addition to slower movements, be useful for characterization of neck pain disorders and for evaluation of rehabilitation. Evaluation of whether impairments in cervical rotation speed is associated with symptoms and self-rated functioning would add information about the clinical validity of such tests
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