de Zoete RMJ1,2,3,4, Osmotherly PG2,3,4, Rivett DA2,3,4, Snodgrass SJ2,3,4
1Recover Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Australia, 2The University of Newcastle, School of Health Sciences, Callaghan, Australia, 3Hunter Medical Research Institute, Newcastle, Australia, 4Centre for Brain and Mental Health Research, The University of Newcastle, Callaghan, Australia
Background: Sensorimotor control is rapidly gaining interest in both clinical practice and neck pain research. Sensorimotor control is guided by multiple subsystems describing four afferent-efferent information interactions: proprioception, kinesthesis, visuomotor control, and the vestibular system. Seven tests have been reported to assess cervical sensorimotor control in individuals with neck pain: joint position error (conventional and torsion), postural balance, subjective visual vertical, head tilt response, The Fly®, smooth pursuit neck torsion and head steadiness. However, it is unknown whether different tests assess the same, or different subsystems of sensorimotor control. It is unclear whether clinicians could use one test, or a test battery, to appropriately assess cervical sensorimotor control, potentially saving valuable time and resources.
Purpose: To investigate whether seven cervical sensorimotor control tests measure unique or similar characteristics of sensorimotor control in individuals with chronic idiopathic neck pain?
Methods: Principle components factor analysis was used to investigate data from seven cervical sensorimotor control tests, assessed in 50 participants with chronic idiopathic neck pain. Individual factors, potentially related to sensorimotor control, were determined by Eigen values >1.00 and inspection of a loading plot. Items with loadings ≥0.40 were considered satisfactory for inclusion in a factor.
Results: In the factor analysis, all seven cervical sensorimotor control tests were found to measure different skills. Four factors were isolated: postural balance (Eigen value 3.15), head steadiness (Eigen value 2.06), continuous movement accuracy (Eigen value 1.55), and perceived verticality (Eigen value 1.49). Two of these, postural balance and head steadiness, accounted for most of the variance across the tests. The remaining two factors, continuous movement accuracy and perceived verticality, contributed less to the observed variance.
Conclusion(s): Postural balance and head steadiness were the major underlying factors explaining cervical sensorimotor control in the current sample. However, our results imply that all seven tests measure different skills, i.e. all tests are independent and cannot be grouped according to the four subsystems of sensorimotor control.
Implications: As all seven cervical sensorimotor control tests measure unique skills, and these appear to be independent of each other, it is not possible to recommend one test, or a test battery, for clinical practice. Until more complete tests are available that address multiple subsystems, clinicians and researchers cannot assume a single test comprehensively evaluates cervical sensorimotor control, as each included test appeared to assess a unique characteristic.
Keywords: Neck pain, Neck Pain, Proprioception
Funding acknowledgements: This work was supported by Felicity and Michael Thomson through the Hunter Medical Research Institute, grant no. G160129.
Purpose: To investigate whether seven cervical sensorimotor control tests measure unique or similar characteristics of sensorimotor control in individuals with chronic idiopathic neck pain?
Methods: Principle components factor analysis was used to investigate data from seven cervical sensorimotor control tests, assessed in 50 participants with chronic idiopathic neck pain. Individual factors, potentially related to sensorimotor control, were determined by Eigen values >1.00 and inspection of a loading plot. Items with loadings ≥0.40 were considered satisfactory for inclusion in a factor.
Results: In the factor analysis, all seven cervical sensorimotor control tests were found to measure different skills. Four factors were isolated: postural balance (Eigen value 3.15), head steadiness (Eigen value 2.06), continuous movement accuracy (Eigen value 1.55), and perceived verticality (Eigen value 1.49). Two of these, postural balance and head steadiness, accounted for most of the variance across the tests. The remaining two factors, continuous movement accuracy and perceived verticality, contributed less to the observed variance.
Conclusion(s): Postural balance and head steadiness were the major underlying factors explaining cervical sensorimotor control in the current sample. However, our results imply that all seven tests measure different skills, i.e. all tests are independent and cannot be grouped according to the four subsystems of sensorimotor control.
Implications: As all seven cervical sensorimotor control tests measure unique skills, and these appear to be independent of each other, it is not possible to recommend one test, or a test battery, for clinical practice. Until more complete tests are available that address multiple subsystems, clinicians and researchers cannot assume a single test comprehensively evaluates cervical sensorimotor control, as each included test appeared to assess a unique characteristic.
Keywords: Neck pain, Neck Pain, Proprioception
Funding acknowledgements: This work was supported by Felicity and Michael Thomson through the Hunter Medical Research Institute, grant no. G160129.
Topic: Musculoskeletal: spine
Ethics approval required: Yes
Institution: The University of Newcastle
Ethics committee: Human Research Ethics Committee
Ethics number: H-2016-0099
All authors, affiliations and abstracts have been published as submitted.
