Background & Aims
The assessment of movement quality (jerk), range of motion (ROM), and head repositioning accuracy (HRA) has gained considerable attention due to its relevance in identifying sensorimotor impairments in clinical populations (1). Uncertainty remains regarding the number of measurements needed to obtain reliable results in both clinical and healthy populations, as underscored in a recent review (2). This study aimed to examine the test-retest reliability for healthy individuals’ jerk, ROM, and HRA during cervical rotations.
Methods
Thirty healthy participants were included in this study. Ten repetitions of each task (ROM, HRA) were performed in a randomized and balanced order, with half of the participants starting with an assessment of ROM in cervical rotation followed by the HRA test and vice versa. HRA was defined as the difference between the start and end positions, i.e., when the participants returned to their self-perceived neutral position. During the assessment of HRA, participants were blindfolded and wore hearing protection. Following each HRA repetition, the assessor repositioned the participant’s head back to the self-perceived neutral position guided by a laser level. No feedback was provided regarding participants’ performance, and head adjustments following an HRA repetition were made regardless of the accuracy. Kinematics were recorded using an inertial measurement unit (IMU) (MOTI, Aalborg, Denmark) (3,4). Error and inter-class correlation (ICC) were calculated between the test and re-test.
Results
The error for jerk was 0±0 Log(10)s after ten repetitions, the ICC increased from 0.65 to above 0.85 when the mean of two or more repetitions was used. The ROM re-test had an error of 0 ± 0.1? after ten repetitions. The ICC values were consistently between 0.84 – 0.91, irrespective of the number of repetitions used for calculating a mean ROM. The re-test of HRA had an error of 0.3 ± 0.1?, the ICC showed consistently poor results with values around 0.25 regardless of the number of repetitions. ROM and jerk reached a plateau after 2-3 measurements and HRA after five measures.
Conclusions
Based on test-retest findings, three repetitions are recommended, as ICC values show marginal improvement beyond 2-3 repetitions, providing limited additional value. The ICC values for HRA were poor. However, it is noteworthy that the measurement error is 0.3 ± 0.1? after three repetitions, which is below the clinically significant difference of 3-4.5? observed in previous studies (5). Therefore, despite the poor ICC values, the measurement may still help identify sensorimotor disturbances in a clinical setting, given its low error rate.
References
1.Balasubramanian S, Melendez-Calderon A, Roby-Brami A, Burdet E. On the analysis of movement smoothness. J Neuroeng Rehabil. 2015;12(1):1–11.
2.AlDahas A, Heneghan NR, Althobaiti S, Deane JA, Rushton A, Falla D. Measurement properties of cervical joint position error in people with and without neck pain: a systematic review and narrative synthesis. BMC Musculoskelet Disord. 2024;25(1):1–19.
3.Christensen SWMP, Palsson TS, Djurtoft C, Simonsen MB. Agreement between a 3D camera system and an inertial measurement unit for assessing the range of motion, head repositioning accuracy and quality of movement during neck and head movements. Eur J Physiother [Internet]. 2023 [cited 2023 Aug 21]; Available from: https://www.tandfonline.com/doi/abs/10.1080/21679169.2023.2198562
4.Bellosta-López P, Simonsen MB, Palsson TS, Djurtoft C, Hirata RP, Christensen SWMP. Validity of an inertial measurement unit for the assessment of range and quality of movement during head and thoracic spine movements. Musculoskelet Sci Pract. 2023 Aug 1;66:102826.
5.Stanton TR, Leake HB, Chalmers KJ, Moseley GL. Evidence of impaired proprioception in chronic, idiopathic neck pain: systematic review and meta-analysis. Phys Ther. 2016;96(6):876–87.
Presenting Author
Steffan W. M. Christensen
Poster Authors
Steffan Wittrup McPhee Christensen PhD
PhD
Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark
Lead Author
Morten Simonsen (PhD)
Department of Materials and Production, Aalborg University
Lead Author
Tróndur Tróndarson (MSc)
Department of Health Science and Technology, Faculty of Medicine, Aalborg University
Lead Author
Diego Martínez-Echevarría (MSc)
Department of Materials and Production, Aalborg University
Lead Author
Thorvaldur Pálsson (PhD)
Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital
Lead Author
Topics
- Specific Pain Conditions/Pain in Specific Populations: Neck Pain