A Pilot Longitudinal Study of 3-Dimensional Head and Neck Kinematics During Functional Tasks in Individuals With Chronic Idiopathic Neck Pain Either Wait-Listed for or Receiving Chiropractic Spinal Manipulative Therapy With Exercise.

OBJECTIVE: The purpose of this study was to determine if there is a relationship between pain and movement kinematics during functional tasks, evaluated over time, in individuals with chronic idiopathic neck pain. METHODS: Ten participants with chronic idiopathic neck pain performed 2 functional tasks (overhead reach to the right and putting on a seatbelt) while evaluated using 8 Oqus 300+ cameras. Kinematic variables included joint angles and range of motion (ROM) (°), head segment relative to neck segment (head-neck [HN]); and head/neck segment relative to upper thoracic segment (head/neck-trunk), velocity (m/s), and time (% of movement phase). Pain was quantified using a 100-mm visual analog scale. Linear mixed effects regression models were used to analyze associations between pain and kinematic variables adjusting for treatment group. RESULTS: For overhead reach, higher pain was associated with less HN peak rotation at baseline (ß = -0.33; 95% CI -0.52 to -0.14, P = .003) and less HN total rotation ROM at 6 months (ß = -0.19; 95% CI -0.38 to -0.003, P = .048). For the seatbelt task, higher pain was associated with less HN peak rotation (ß = -0.52; 95% CI -0.74 to -0.30 to -0.74, P < .001) and less HN total rotation ROM at baseline (ß = -0.32; 95% CI -0.53 to -0.10, P = .006). No other movement variables demonstrated meaningful relationships with pain for the reach or seatbelt tasks. CONCLUSION: Higher pain is associated with less HN peak and total rotation during functional reaching tasks requiring head rotation. Recognizing altered functional kinematics in individuals with chronic neck pain may assist patient management.

Comparisons of cervical and thoracic spine kinematic joint and body segment angles, timing, and velocity between individuals with and without chronic idiopathic neck pain during functional tasks.

BACKGROUND: Few studies comprehensively analyse 3D neck kinematics in individuals with chronic idiopathic neck pain during functional tasks considered challenging. This critical knowledge is needed to assist clinicians to recognise and address how altered movement strategies might contribute to pain. RESEARCH QUESTION: Are there differences in 3D neck kinematics (angles, timing, velocity) during functional tasks in people with chronic neck pain compared to matched asymptomatic control participants? METHODS: Participants with chronic idiopathic neck pain (n = 33) and matched asymptomatic controls (n = 30) performed four functional tasks (overhead reach forward, right and left, and putting on a seatbelt) while evaluated using 3D motion capture. Kinematic variables included joint angles, range of motion (ROM,°), velocity (m s-1) and timing (% of movement phase) for joint angles (head-neck [HN joint], head+neck-upper trunk [HNT], and thoracolumbar) and segments (head, neck, head+neck [HN segment], upper trunk, and trunk. Generalised linear mixed models examined between-group differences. RESULTS: There were few between-group differences. The neck pain group had less HN segment extension that controls (mean difference [MD] left -2.06°; 95% CI -3.82, -0.29; p = .023; and right reach -2.52°; -4.67, -0.37; P = .022), and had less total sagittal HNT ROM across all tasks (-1.28; 95% CI -2.25, -0.31; p = .010). Approaching significance was the pain group having less thoracolumbar left rotation than controls (MD -2.14, 95% CI -4.41 to 0.13, p = .064). The pain group had higher neck segment peak flexion velocity than controls across all tasks (MD -3.09; 95% CI -5.21 to -0.10; P = .004). Timing of joint angle peaks did not differ between groups. SIGNIFICANCE: When performing an overhead reach task to the left and right and putting on a seatbelt, people with neck pain maintain a more flexed HN segment, use less sagittal ROM and have higher velocity peaks. These findings can assist clinicians in their assessment of patients by identifying possible underlying contributors to neck pain.

Differences in the kinematics of the cervical and thoracic spine during functional movement in individuals with or without chronic neck pain: a systematic review.

BACKGROUND: Chronic neck pain is common, impacting a person's ability to complete functional tasks. One method of quantifying functional movement is three dimensional (3D) motion analysis, however, it is unknown whether it may detect alterations in movement kinematics in individuals with neck pain. OBJECTIVE: To systematically review studies to determine possible differences in cervical and thoracic kinematics during functional movement as measured by 3D motion analysis in individuals with neck pain compared to controls. DATA SOURCES: Medline, Amed, Scopus, Cochrane, Embase, CINAHL searched on 11/11/2017. STUDY SELECTION: Studies reported 3D kinematics of functional movement (based on real-world situational biomechanics, i.e., multi-planar movements) of the cervical and thoracic spine in individuals with and without neck pain. STUDY APPRAISAL AND SYNTHESIS: Two reviewers assessed study quality; studies were summarised using discussion. RESULTS: Four thousand four hundred and sixteen title/abstracts were screened, 11 full texts retrieved. Common reasons for exclusion were participants ≤8years of age and studies that did not investigate functional movement. Included studies (n=5) used 3D motion analysis to assess kinematics during functional tasks including typing, gaming and resting posture. Participants with neck pain displayed greater neck flexion postures, reduced head velocity and smoothness of movement. LIMITATIONS: Variations in measurement methods and participant samples prevented meta-analysis. CONCLUSION: Though few studies were identified, altered kinematics were observed in individuals with neck pain, suggesting further research examining cervical spine kinematics is warranted. Recognising kinematic differences is important for clinicians to identify possible movement risk factors in individuals with neck pain that may be targeted with treatment. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO: CRD42017076053.