Skip to main content
Top
Published in: European Spine Journal 7/2016

01-07-2016 | Original Article

Neck motion kinematics: an inter-tester reliability study using an interactive neck VR assessment in asymptomatic individuals

Authors: Hilla Sarig Bahat, Elliot Sprecher, Itamar Sela, Julia Treleaven

Published in: European Spine Journal | Issue 7/2016

Login to get access

Abstract

Background and Purpose

The use of virtual reality (VR) for assessment and intervention of neck pain has previously been used and shown reliable for cervical range of motion measures. Neck VR enables analysis of task-oriented neck movement by stimulating responsive movements to external stimuli. Therefore, the purpose of this study was to establish inter-tester reliability of neck kinematic measures so that it can be used as a reliable assessment and treatment tool between clinicians.

Methods

This reliability study included 46 asymptomatic participants, who were assessed using the neck VR system which displayed an interactive VR scenario via a head-mounted device, controlled by neck movements. The objective of the interactive assessment was to hit 16 targets, randomly appearing in four directions, as fast as possible. Each participant was tested twice by two different testers.

Results

Good reliability was found of neck motion kinematic measures in flexion, extension, and rotation (0.64–0.93 inter-class correlation). High reliability was shown for peak velocity globally (0.93), in left rotation (0.9), right rotation and extension (0.88), and flexion (0.86). Mean velocity had a good global reliability (0.84), except for left rotation directed movement with moderate reliability (0.68). Minimal detectable change for peak velocity ranged from 41 to 53 °/s, while mean velocity ranged from 20 to 25 °/s.

Conclusions

The results suggest high reliability for peak and mean velocity as measured by the interactive Neck VR assessment of neck motion kinematics. VR appears to provide a reliable and more ecologically valid method of cervical motion evaluation than previous conventional methodologies.
Literature
1.
go back to reference Lidgren L (2008) Preface: neck pain and the decade of the bone and joint 2000–2010. Spine 33:S1–S2CrossRef Lidgren L (2008) Preface: neck pain and the decade of the bone and joint 2000–2010. Spine 33:S1–S2CrossRef
2.
go back to reference Hogg-Johnson S, van der Velde G, Carroll LJ, Holm LW, Cassidy JD, Guzman J, Cote P, Haldeman S, Ammendolia C, Carragee E, Hurwitz E, Nordin M, Peloso P (2008) The burden and determinants of neck pain in the general population: results of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders. Spine 33:S39–S51CrossRefPubMed Hogg-Johnson S, van der Velde G, Carroll LJ, Holm LW, Cassidy JD, Guzman J, Cote P, Haldeman S, Ammendolia C, Carragee E, Hurwitz E, Nordin M, Peloso P (2008) The burden and determinants of neck pain in the general population: results of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders. Spine 33:S39–S51CrossRefPubMed
3.
go back to reference Childs JD, Cleland JA, Elliott JM, Teyhen DS, Wainner RS, Whitman JM, Sopky BJ, Godges JJ, Flynn TW (2008) Neck pain: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the American physical therapy association. J Orthop Sports Phys Ther 38:A1–A34CrossRefPubMed Childs JD, Cleland JA, Elliott JM, Teyhen DS, Wainner RS, Whitman JM, Sopky BJ, Godges JJ, Flynn TW (2008) Neck pain: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the American physical therapy association. J Orthop Sports Phys Ther 38:A1–A34CrossRefPubMed
4.
go back to reference Chiu TTW, Lo SK (2002) Evaluation of cervical range of motion and isometric neck muscle strength: reliability and validity. Clin Rehab 16(8):851–858CrossRef Chiu TTW, Lo SK (2002) Evaluation of cervical range of motion and isometric neck muscle strength: reliability and validity. Clin Rehab 16(8):851–858CrossRef
5.
go back to reference Falla D (2004) Unravelling the complexity of muscle impairment in chronic neck pain. Man Ther 9:125–133CrossRefPubMed Falla D (2004) Unravelling the complexity of muscle impairment in chronic neck pain. Man Ther 9:125–133CrossRefPubMed
6.
go back to reference O’Leary S, Falla D, Elliott JM, Jull G (2009) Muscle dysfunction in cervical spine pain: implications for assessment and management. J Orthop Sports Phys Ther 39:324–333CrossRefPubMed O’Leary S, Falla D, Elliott JM, Jull G (2009) Muscle dysfunction in cervical spine pain: implications for assessment and management. J Orthop Sports Phys Ther 39:324–333CrossRefPubMed
7.
go back to reference Feipel V, Salvia P, Klein H, Rooze M (2006) Head repositioning accuracy in patients with whiplash-associated disorders. Spine 31:E51–E58CrossRefPubMed Feipel V, Salvia P, Klein H, Rooze M (2006) Head repositioning accuracy in patients with whiplash-associated disorders. Spine 31:E51–E58CrossRefPubMed
9.
go back to reference Sjölander P, Michaelson P, Jaric S, Djupsöbacka M (2008) Sensorimotor disturbances in chronic neck pain- range of motion, peak velocity, smoothness of movement, and repositioning acuity. Man Ther 13:122–131CrossRefPubMed Sjölander P, Michaelson P, Jaric S, Djupsöbacka M (2008) Sensorimotor disturbances in chronic neck pain- range of motion, peak velocity, smoothness of movement, and repositioning acuity. Man Ther 13:122–131CrossRefPubMed
10.
go back to reference Röijezon U, Björklund M, Bergenheim M, Djupsjöbacka M (2008) A novel method for neck coordination exercise—a pilot study on persons with chronic non-specific neck pain. J Neuroeng Rehab. doi:10.1186/1743-0003-1185-1136 Röijezon U, Björklund M, Bergenheim M, Djupsjöbacka M (2008) A novel method for neck coordination exercise—a pilot study on persons with chronic non-specific neck pain. J Neuroeng Rehab. doi:10.​1186/​1743-0003-1185-1136
11.
go back to reference Takasaki H, Treleaven J, Johnston V, Jull G (2013) Contributions of physical and cognitive impairments to self-reported driving difficulty in chronic whiplash-associated disorders. Spine 38:1554–1560CrossRefPubMed Takasaki H, Treleaven J, Johnston V, Jull G (2013) Contributions of physical and cognitive impairments to self-reported driving difficulty in chronic whiplash-associated disorders. Spine 38:1554–1560CrossRefPubMed
12.
go back to reference Sarig Bahat H, Weiss PL, Sprecher E, Krasovsky A, Laufer Y (2014) Do neck kinematics correlate with pain intensity, neck disability or with fear of motion? Man Ther 19:252–258CrossRefPubMed Sarig Bahat H, Weiss PL, Sprecher E, Krasovsky A, Laufer Y (2014) Do neck kinematics correlate with pain intensity, neck disability or with fear of motion? Man Ther 19:252–258CrossRefPubMed
13.
go back to reference Roijezon U, Djupsjobacka M, Bjorklund M, Hager-Ross C, Grip H, Liebermann DG (2010) Kinematics of fast cervical rotations in persons with chronic neck pain: a cross-sectional and reliability study. BMC Musculoskeletal Disorders 11:1–10CrossRef Roijezon U, Djupsjobacka M, Bjorklund M, Hager-Ross C, Grip H, Liebermann DG (2010) Kinematics of fast cervical rotations in persons with chronic neck pain: a cross-sectional and reliability study. BMC Musculoskeletal Disorders 11:1–10CrossRef
14.
go back to reference Niederer D, Vogt L, Wilke J, Rickert M, Banzer W (2015) Age-related cutoffs for cervical movement behaviour to distinguish chronic idiopathic neck pain patients from unimpaired subjects. Eur Spine J 24:493–502. doi:10.1007/s00586-014-3715-y CrossRefPubMed Niederer D, Vogt L, Wilke J, Rickert M, Banzer W (2015) Age-related cutoffs for cervical movement behaviour to distinguish chronic idiopathic neck pain patients from unimpaired subjects. Eur Spine J 24:493–502. doi:10.​1007/​s00586-014-3715-y CrossRefPubMed
16.
go back to reference Rizzo A, Kim GJ (2005) A SWOT analysis of the field of virtual reality rehabilitation and therapy. Presence Teleoperators Virtual Environ 14:119–146CrossRef Rizzo A, Kim GJ (2005) A SWOT analysis of the field of virtual reality rehabilitation and therapy. Presence Teleoperators Virtual Environ 14:119–146CrossRef
17.
go back to reference Kramer M, Honold M, Hohl K, Bockholt U, Rettig A, Elbel M, Dehner C (2009) Reliability of a new virtual reality test to measure cervicocephalic kinaesthesia. J Electromyogr Kinesiol 19:e353–e361CrossRefPubMed Kramer M, Honold M, Hohl K, Bockholt U, Rettig A, Elbel M, Dehner C (2009) Reliability of a new virtual reality test to measure cervicocephalic kinaesthesia. J Electromyogr Kinesiol 19:e353–e361CrossRefPubMed
18.
go back to reference Lee JH, Ku J, Cho W, Hahn WY, Kim IY, Lee S-M, Kang Y, Kim DY, Yu T, Wiederhold BK, Wiederhold MD, Kim SI (2003) A virtual reality system for the assessment and rehabilitation of the activities of daily living. Cyberpsychol Behav 6:383–388CrossRefPubMed Lee JH, Ku J, Cho W, Hahn WY, Kim IY, Lee S-M, Kang Y, Kim DY, Yu T, Wiederhold BK, Wiederhold MD, Kim SI (2003) A virtual reality system for the assessment and rehabilitation of the activities of daily living. Cyberpsychol Behav 6:383–388CrossRefPubMed
19.
go back to reference Lengenfelder J, Schultheis MT, Al-Shibabi T, Mourant R, DeLuca J (2002) Divided attention and driving: a pilot study using virtual reality technology. J Head Trauma Rehab 17:26–37CrossRef Lengenfelder J, Schultheis MT, Al-Shibabi T, Mourant R, DeLuca J (2002) Divided attention and driving: a pilot study using virtual reality technology. J Head Trauma Rehab 17:26–37CrossRef
20.
go back to reference Maani CV, Hoffman HG, Morrow M, Maiers A, Gaylord K, McGhee LL, DeSocio PA (2011) Virtual reality pain control during burn wound debridement of combat-related burn injuries using robot-like arm mounted VR goggles. J Trauma Injury Infect Crit Care 71:S125–S130CrossRef Maani CV, Hoffman HG, Morrow M, Maiers A, Gaylord K, McGhee LL, DeSocio PA (2011) Virtual reality pain control during burn wound debridement of combat-related burn injuries using robot-like arm mounted VR goggles. J Trauma Injury Infect Crit Care 71:S125–S130CrossRef
21.
go back to reference Merians AS, Poizner H, Boian R, Burdea G, Adamovich S (2006) Sensorimotor training in a virtual reality environment: does it improve functional recovery poststroke? Neurorehabil Neural Repair 20:252–267CrossRefPubMed Merians AS, Poizner H, Boian R, Burdea G, Adamovich S (2006) Sensorimotor training in a virtual reality environment: does it improve functional recovery poststroke? Neurorehabil Neural Repair 20:252–267CrossRefPubMed
22.
go back to reference Sarig Bahat H, Weiss PL, Laufer Y (2009) Cervical motion assessment using virtual reality. Spine 34:1018–1024CrossRefPubMed Sarig Bahat H, Weiss PL, Laufer Y (2009) Cervical motion assessment using virtual reality. Spine 34:1018–1024CrossRefPubMed
23.
go back to reference Sarig Bahat H, Chen X, Reznik D, Kodesh E, Treleaven J (2015) Interactive cervical motion kinematics: sensitivity, specificity and clinically significant values for identifying kinematic impairments in patients with chronic neck pain. Man Ther 20:295–302. doi:10.1016/j.math.2014.10.002 CrossRefPubMed Sarig Bahat H, Chen X, Reznik D, Kodesh E, Treleaven J (2015) Interactive cervical motion kinematics: sensitivity, specificity and clinically significant values for identifying kinematic impairments in patients with chronic neck pain. Man Ther 20:295–302. doi:10.​1016/​j.​math.​2014.​10.​002 CrossRefPubMed
24.
go back to reference Sarig-Bahat H, Weiss PL, Laufer Y (2010) Neck pain assessment in a virtual environment. Spine 35:E105–E112CrossRefPubMed Sarig-Bahat H, Weiss PL, Laufer Y (2010) Neck pain assessment in a virtual environment. Spine 35:E105–E112CrossRefPubMed
25.
go back to reference Hogan N (1984) An organizing principle for a class of voluntary movements. J Neurosci 4:2745–2754PubMed Hogan N (1984) An organizing principle for a class of voluntary movements. J Neurosci 4:2745–2754PubMed
26.
28.
go back to reference Bland J, Altman D (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310CrossRefPubMed Bland J, Altman D (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310CrossRefPubMed
30.
go back to reference Sarig Bahat H, Weiss PL, Laufer Y (2010) The effect of neck pain on cervical kinematics, as assessed in a virtual environment. Arch Phys Med Rehabil 91:1884–1890CrossRefPubMed Sarig Bahat H, Weiss PL, Laufer Y (2010) The effect of neck pain on cervical kinematics, as assessed in a virtual environment. Arch Phys Med Rehabil 91:1884–1890CrossRefPubMed
31.
go back to reference Chen J, Solinger AB, Poncet JF, Lantz CA (1999) Meta-analysis of normative cervical motion. Spine 24:1571–1578CrossRefPubMed Chen J, Solinger AB, Poncet JF, Lantz CA (1999) Meta-analysis of normative cervical motion. Spine 24:1571–1578CrossRefPubMed
32.
go back to reference Assink N, Bergman GJD, Knoester B, Winters JC, Dijkstra PU, Postema K (2005) Interobserver reliability of neck-mobility measurement by means of the flock-of-birds electromagnetic tracking system. J Manip Physiol Ther 28:408–413 Assink N, Bergman GJD, Knoester B, Winters JC, Dijkstra PU, Postema K (2005) Interobserver reliability of neck-mobility measurement by means of the flock-of-birds electromagnetic tracking system. J Manip Physiol Ther 28:408–413
34.
go back to reference Cagnie B, Cools A, De Loose V, Cambier D, Danneels L (2007) 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. J Manip Physiol Ther 30:450CrossRef Cagnie B, Cools A, De Loose V, Cambier D, Danneels L (2007) 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. J Manip Physiol Ther 30:450CrossRef
36.
go back to reference Juul T, Langberg H, Enoch F, Sogaard K (2013) The intra- and inter-rater reliability of five clinical muscle performance tests in patients with and without neck pain. BMC Musculoskelet Disord 14:339CrossRefPubMedPubMedCentral Juul T, Langberg H, Enoch F, Sogaard K (2013) The intra- and inter-rater reliability of five clinical muscle performance tests in patients with and without neck pain. BMC Musculoskelet Disord 14:339CrossRefPubMedPubMedCentral
37.
go back to reference Treleaven J, Battershill J, Cole D, Fadelli C, Freestone S, Lang K, Sarig- Bahat H (2015) Virtual reality for neck rehabilitation: simulator sickness incidence and susceptibility. Virtual Real. doi:10.1007/s10055-015-0266-4 Treleaven J, Battershill J, Cole D, Fadelli C, Freestone S, Lang K, Sarig- Bahat H (2015) Virtual reality for neck rehabilitation: simulator sickness incidence and susceptibility. Virtual Real. doi:10.​1007/​s10055-015-0266-4
Metadata
Title
Neck motion kinematics: an inter-tester reliability study using an interactive neck VR assessment in asymptomatic individuals
Authors
Hilla Sarig Bahat
Elliot Sprecher
Itamar Sela
Julia Treleaven
Publication date
01-07-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 7/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4388-5

Other articles of this Issue 7/2016

European Spine Journal 7/2016 Go to the issue