High-vs. low-tech cervical movement sense measurement in individuals with neck pain

Objectives: To compare diagnostic ability of the clinical cervical movement sense (CCMS) test to the neck virtual reality (VR) system accuracy module. Background: Altered cervical proprioception is common in patients with persistent neck pain (NP). Recently a simple CCMS has been found to be feasible and reliable. However, it is not known how this compares to a valid method. Methods: Twenty participants with persistent NP and 20 healthy controls were videoed while performing the CCMS using a laser pointer and traced a zigzag pattern and then assessed using the VR accuracy module which consisted of following 8 segments in four directions. Diagnostic ability using a model from potential variables from the video analysis of number of errors and task performance time was compared to a model provided from VR data. Results: Subjects with NP had significantly greater horizontal errors in the CCMS and VR accuracy. Both CCMS and VR measurement models utilising measurements of horizontal movement error demonstrated good diagnostic ability (AUC = 0.88, 0.91 respectively) and there was no statistical difference between the models’ AUC (p = 0.7). Conclusion: The simple clinical testing tool appears to provide a measure of cervical movement sense, similar to the established Neck VR accuracy measure. Both tools differentiated individuals with NP from controls with similar sensitivity and specificity, with some advantage to the VR. The rotational motion measures seem most suitable in the assessment of motion accuracy. CCMS has potential to be used as a simple clinical measure and warrants further research