Clinical assessment of cervical movement sense in those with neck pain compared to asymptomatic individuals

Tracing a zigzag- and a figure-of-8-pattern (with a laser pointer fixed on the head) is an easy and affordable way to test movement sense of the cervical spine.

After testing reliability and feasibility of this test(see blog 12/11/2018), there are now results of a comparison between neck pain subjects and asymptomatic participants. Furthermore two subgroups (idiopathic neck pain vs. WAD) have been compared. Have a look at the abstract!

Free full-text available until 21th August 2019, copy this link into your browser: https://authors.elsevier.com/c/1ZKBk8nLVhYvAX

Clinical assessment of cervical movement sense in those with neck pain compared to asymptomatic individuals

Markus J. Ernst, Lauren Williams, Isabelle M. Werner, Rebecca J. Crawford, Julia Treleaven

Abstract

Background:A simple clinical test involving subject tracing zigzag (ZZ) and figure of eight (F8) patterns with a head mounted laser device in determining cervical movement sense has proven reliability and feasibility. However, its validity in comparing individuals with and without neck pain (NP) has not been examined.

Methods:Seventy-six subjects (38 NP and 38 asymptomatic subjects) performed both patterns while motion of their laser point was videoed. Independent examiners subsequently rated the videos (real-time) to record the time needed and the number of errors when completing each task. Sensitivity, specificity, and positive and negative likelihood ratios (LR+ and LR-) for various cut-offs to optimise clinical interpretation were determined. Comparisons between 25 subjects with idiopathic neck pain versus 13 with whiplash-associated disorders were also undertaken.

Results:All outcome variables except ZZ time were significantly different between individuals with NP and controls. Optimal cut-offs of 9 and 10 errors yielded LR+/LR- of 3.67/0.17 (F8) and 3.00/0.38 (ZZ). Whiplash patients performed the ZZ task faster with similar errors to those with idiopathic neck pain.

Conclusion:The clinical utility of this inexpensive measure to assess cervical movement sense in people with NP is supported. Moderate LRs+ were demonstrated for number of errors for both patterns. Individuals with NP generated significantly more errors while tracing each pattern. Optimal cut offs of 9 errors for ZZ and 10 errors for F8 were established. Overall, these tests appear to be clinically suitable to determine altered cervical movement sense in those with NP.

#neckpain #movementsense #cervicalmovementsense #cervicalspine #nonspecificneckpain #nsnp  #wad #whiplash

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