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Remote kinematic training for patients with chronic neck pain: a randomised controlled trial

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Abstract

Purpose

To evaluate short- and intermediate-term effects of kinematic training (KT) using virtual reality (VR) or laser in patients with chronic neck pain.

Methods

A randomised controlled trial with three arms (laser, VR, control) to post-intervention (N = 90), and two arms (laser or VR) continuing to 3 months follow-up. Home training intervention was provided during 4 weeks to VR and laser groups while control group waited.

Outcome measures

Primary outcome measures included neck disability index (NDI), global perceived effect (GPE), and cervical motion velocity (mean and peak). Secondary outcome measures included pain intensity (VAS), health status (EQ5D), kinesiophobia (TSK), range, smoothness, and accuracy of neck motion as measured by the neck VR system. Measures were taken at baseline, immediately post-training, and 3 months later.

Results

Ninety patients with neck pain were randomised to the trial, of which 76 completed 1 month follow-up, and 56 the 3 months follow-up. Significant improvements were demonstrated in NDI and velocity with good effect sizes in intervention groups compared to control. No within-group changes were presented in the control group, compared to global improvements in intervention groups. Velocity significantly improved at both time points in both groups. NDI, VAS, EQ5D, TSK and accuracy significantly improved at both time points in VR and in laser at 3 months evaluation in all but TSK. GPE scores showed 74–84% of participants perceived improvement and/or were satisfied. Significant advantages to the VR group compared to laser were found in velocity, pain intensity, health status and accuracy at both time points.

Conclusion

The results support home kinematic training using VR or laser for improving disability, neck pain and kinematics in the short and intermediate term with an advantage to the VR group. The results provide directions for future research, use and development.

Trial registration

ACTRN12615000231549.

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Acknowledgements

This work was funded by the Physiotherapy Research Fellowships (HMR), provided by Queensland Health, Health and Medical Research, Preventive Health Unit.

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Authors and Affiliations

  1. CCRE Spine SHRS, University of Queensland, St. Lucia, Brisbane, Queensland, Australia

    Kate Croft, Courtney Carter, Anna Hoddinott & Julia Treleaven

  2. The Department of Physical Therapy, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, 3498838, Haifa, Israel

    Hilla Sarig Bahat & Elliot Sprecher

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  1. Hilla Sarig Bahat
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  2. Kate Croft
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Correspondence to Hilla Sarig Bahat.

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Funding

Funding was supported by Queensland Government (2013003214).

Ethics approval

This study was approved by the Human Medical Research Ethics Committee, University of Queensland, and registered by the Australian New Zealand Clinical Trials Registry—trial registration ACTRN12615000231549.

Conflict of interest

The authors declare that they have no competing interests.

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Sarig Bahat, H., Croft, K., Carter, C. et al. Remote kinematic training for patients with chronic neck pain: a randomised controlled trial. Eur Spine J 27, 1309–1323 (2018). https://doi.org/10.1007/s00586-017-5323-0

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  • DOI: https://doi.org/10.1007/s00586-017-5323-0

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