Cervical kinematic training with and without interactive VR training for chronic neck pain

Impairments in cervical kinematics are frequently found in patients with neck pain. A virtual reality (VR) device could potentially be effective in the management of these impairments. The aim of this study was to investigate the effect of kinematic training (KT) with and without the use of an interactive VR device. In this assessor-blinded, allocation-concealed pilot clinical trial, 32 participants with chronic neck pain were placed at random into the KT or kinematic plus VR training (KTVR) group. Both groups completed four to six training sessions comprising of similar KT activities including active and quick head movements and fine head movement control and stability over five weeks. Only the KTVR group used the VR device. The primary outcome measures were neck disability index (NDI), cervical range of motion (ROM), head movement velocity and accuracy. Kinematic measures were collected using the VR system that was used for training as well. Secondary measures included pain intensity, TAMPA scale of kinesiophobia, static and dynamic balance, global perceived effect and participant satisfaction. The results demonstrated significant (p<0.05) improvements in NDI, ROM (rotation), velocity, and the step test in both groups post-intervention. At 3-month post-intervention, these improvements were mostly sustained; however there was no control group, which limits the interpretation of this. Between-group analysis showed a few specific differences including global perceived change that was greater in the KTVR group.

This pilot study has generated directions and cause for future research exploring training which employs kinematic training and VR for those with neck pain in a larger cohort.