Cervical Proprioception Evaluation And Its Correlation With Cervical Imaging Features

Part I Reliability and validity of a novel device for evaluating cervical proprioceptionObjectivesIn clinical practice,cervical proprioception is usually evaluated by calculating the cervical joint position error(JPE)with laser pointer devices or cervical range-of-motion(CROM)instruments.As technology continues to improve,more and more advanced tools are being used to evaluate cervical proprioception.The purpose of this study was to analyze the reliability and validity of a novel intelligent sensor device in evaluating cervical proprioception.MethodsA total of 28 healthy subjects(16 women,12 men)were recruited,and neck JPE was evaluated by two experienced evaluators using a laser pointer device and a Wit-motion sensor device.The reliability and validity of the Wit-motion sensor device were analyzed by calculating the Intraclass correlation coefficient(ICC),Spearman’s correlation coefficient and Lo A.ResultsThe intra-rater reliability with the Wit-motion sensor(ICC =0.682-0.774)was higher than that of the laser pointer device(ICC =0.512-0.719)for measuring cervical JPE of cervical flexion,right lateral flexion,left rotation.However,the laser pointer device(ICC =0.767-0.796)outperformed the Wit-motion sensor(ICC =0.507-0.661)in cervical extension,left lateral flexion,and right rotation.For the inter-rater reliability,the ICC values obtained by the laser pointer device were above 0.700 for all cervical movements.The ICC values obtained by the Wit-motion sensor was higher than 0.700 for measuring cervical JPE of cervical flexion,right lateral flexion,rotation.Compared the consistency of the two devices,the ICC values were not less than 0.614(ICC= 0.614-0.869)for all cervical movements.ConclusionBased on the moderate to excellent intra-and inter-rater reliability,the novel device can be an alternative tool to evaluate cervical proprioception in clinical practice.Part II Relationship between cervical proprioception and cervical imaging features in patients with chronic neck painObjectivesPatients with chronic neck pain are usually accompanied by impaired neck proprioception.Exploring the relationship between cervical proprioceptive function and cervical imaging is conducive to comprehensively evaluate the cervical function status in patients with chronic pain.The purpose of this study was to analyze whether the cervical proprioception in patients with chronic neck pain was related to the degree of cervical disc degeneration.MethodsIn this study,the degree of cervical disc degeneration and cervical proprioception were evaluated in patients with chronic neck pain.Radiographically,the discs at C2-3,C3-4,C4-5,C5-6,C6-7 and C7-T1 were evaluated according to the modified Pfirrmann scale,the modified Thompson scale and the Nakashima scale scoring system,and the total disc grading score was calculated for each subject.The cervical Cobb Angle was measured by sagittal T2-weighted images of cervical magnetic resonance.The laser pointer device was used to evaluate subjects’ cervical proprioception,and the Visual Analogue Scale(VAS)was used to evaluate subjects’ neck pain intensity.The Neck Disability Index(NDI)was used to assesse the degree of cervical disability in subjects.Spearman correlation analysis was used to analyze the relationship between imaging changes and clinical function.ResultsA total of 228 intervertebral disc degeneration cases were evaluated in 38 patients with neck pain,and the mean modified Pfirrmann score of C5-C6 intervertebral disc was the highest(4.29 points).The cervical Joint Position Error(JPE)was significantly higher in patients with chronic neck pain than in healthy subjects.Correlation analysis showed that neck pain intensity was significantly positively correlated with cervical proprioception dysfunction(r=0.40-0.73,P<0.05).Cervical proprioception was correlated with the sum f modified Pfirrmann grade in the direction of left flexion,left rotation and right rotation(r= 0.39-0.52,P < 0.05).ConclusionThe more severe the neck proprioception damage,the more severe the symptoms of neck pain.Cervical proprioception was associated with cervical disc degeneration in the direction of left flexion,left rotation and right rotation.