Kinematics of fast cervical rotations in persons with chronic neck pain: a cross-sectional and reliability study

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.

[1]  G Atkinson,et al.  Statistical Methods For Assessing Measurement Error (Reliability) in Variables Relevant to Sports Medicine , 1998, Sports medicine.

[2]  J. Farrar,et al.  Core outcome measures for chronic pain clinical trials: IMMPACT recommendations , 2003, Pain.

[3]  N. Milne,et al.  Composite motion in cervical disc segments. , 1993, Clinical biomechanics.

[4]  G. Jull,et al.  A study of five cervicocephalic relocation tests in three different subject groups , 2003, Clinical rehabilitation.

[5]  Movement behaviour in patients with chronic neck pain. , 2007, Physiotherapy research international : the journal for researchers and clinicians in physical therapy.

[6]  Fredrik Öhberg,et al.  Chronic whiplash associated disorders and neck movement measurements: an instantaneous helical axis approach , 2003, IEEE Transactions on Information Technology in Biomedicine.

[7]  V. Feipel,et al.  The use of disharmonic motion curves in problems of the cervical spine , 1999, International Orthopaedics.

[8]  Marsha P. Johnson.  Statistical Methods for Health Care Research , 1996 .

[9]  W G Hopkins,et al.  Measures of Reliability in Sports Medicine and Science , 2000, Sports medicine.

[10]  T. Flash,et al.  The coordination of arm movements: an experimentally confirmed mathematical model , 1985, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[11]  R. B. Margolis,et al.  A rating system for use with patient pain drawings , 1986, Pain.

[12]  G. Stelmach,et al.  Developmental Features of Rapid Aiming Arm Movements Across the Lifespan , 2000, Journal of motor behavior.

[13]  J. Weir.  Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. , 2005, Journal of strength and conditioning research.

[14]  Barbara Cagnie,et al.  Reliability and normative database of the Zebris cervical range-of-motion system in healthy controls with preliminary validation in a group of patients with neck pain. , 2007, Journal of manipulative and physiological therapeutics.

[15]  B. Munro.  Statistical methods for health care research , 1986 .

[16]  Gunnevi Sundelin,et al.  Cervical helical axis characteristics and its center of rotation during active head and upper arm movements-comparisons of whiplash-associated disorders, non-specific neck pain and asymptomatic individuals. , 2008, Journal of biomechanics.

[17]  Mary A. Shook,et al.  Chronic Work-Related Myalgia: Neuromuscular Mechanisms Behind Work-Related Chronic Muscle Pain Syndromes , 2008 .

[18]  Ware J.E.Jr.,et al.  THE MOS 36- ITEM SHORT FORM HEALTH SURVEY (SF- 36) CONCEPTUAL FRAMEWORK AND ITEM SELECTION , 1992 .

[19]  C. André-deshays,et al.  Cervicocephalic kinesthetic sensibility in patients with cervical pain. , 1991, Archives of physical medicine and rehabilitation.

[20]  Epilogue: an integrated model for chronic work-related myalgia "Brussels Model" , 2003 .

[21]  J. P. Lund,et al.  The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity. , 1991, Canadian journal of physiology and pharmacology.

[22]  S. Jaric,et al.  Sensorimotor disturbances in chronic neck pain--range of motion, peak velocity, smoothness of movement, and repositioning acuity. , 2008, Manual therapy.

[23]  James G Wright,et al.  Erratum: Development of an upper extremity outcome measure: The DASH (Disabilities of the Arm, Shoulder, and Hand) (American Journal of Industrial Medicine (1996) 29:6 (602-608)) , 1996 .

[24]  C. Warfield,et al.  The measurement of pain. , 1988, Hospital practice.

[25]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[26]  S. Wold,et al.  Orthogonal projections to latent structures (O‐PLS) , 2002 .

[27]  Vladimir M. Zatsiorsky.  Kinematics of human motion , 1998 .

[28]  S. Mior,et al.  The Neck Disability Index: a study of reliability and validity. , 1991, Journal of manipulative and physiological therapeutics.

[29]  P. Hodges,et al.  Patients With Neck Pain Demonstrate Reduced Electromyographic Activity of the Deep Cervical Flexor Muscles During Performance of the Craniocervical Flexion Test , 2004, Spine.

[30]  S. Lo,et al.  Evaluation of cervical range of motion and isometric neck muscle strength: reliability and validity , 2002, Clinical rehabilitation.

[31]  Håkan Johansson,et al.  Chronic Work-Related Myalgia : Neuromuscular Mechanisms behind Work-Related Chronic Muscle Pain Syndromes , 2003 .

[32]  D. Tweed,et al.  Task-Dependent Constraints in Motor Control: Pinhole Goggles Make the Head Move Like an Eye , 2000, The Journal of Neuroscience.

[33]  A. Zeev,et al.  Are localized low back pain and generalized back pain similar entities? Results of a longitudinal community based study , 2006, Disability and rehabilitation.

[34]  O. Vasseljen,et al.  Altered motor control patterns in whiplash and chronic neck pain , 2008, BMC musculoskeletal disorders.

[35]  D. Falla,et al.  Unravelling the complexity of muscle impairment in chronic neck pain. , 2004, Manual therapy.

[36]  C. Bombardier,et al.  Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG) , 1996, American journal of industrial medicine.

[37]  H J Woltring,et al.  Instantaneous helical axis estimation from 3-D video data in neck kinematics for whiplash diagnostics. , 1994, Journal of biomechanics.

[38]  C. Bombardier,et al.  Development of an upper extremity outcome measure: The DASH (disabilities of the arm, shoulder, and head) , 1996 .

[39]  F. Veldpaus,et al.  Finite centroid and helical axis estimation from noisy landmark measurements in the study of human joint kinematics. , 1985, Journal of biomechanics.