Do neck kinematics correlate with pain intensity, neck disability or with fear of motion?

Purpose: This study aimed to investigate the relationship between cervical kinematics and subjective measures, including pain intensity, disability, and fear of motion. Methods: Twenty-five patients (19 females, 6 males; mean age 39 +/- 12.7 years) with chronic neck pain participated in this cross-sectional study. A customized virtual reality system was employed to evaluate cervical range of motion (ROM) and kinematics, using an interactive game controlled by cervical motion via electromagnetic tracking. Self-reported outcome measures included pain intensity (visual analogue scale); disability (Neck Disability Index); and fear of motion (TAMPA scale of kinesiophobia). Kinematic measures included cervical ROM, mean and peak velocity, and number of velocity peaks (NVP) reflecting smoothness of motion. Results: Results showed significant correlations of approximately 0.4-0.6 between ROM and fear of motion, pain intensity, and disability. All 12 kinematic measures were correlated with fear of motion, but only a few were correlated with pain intensity, and with disability. Conclusions: The results emphasise fear of motion as a subjective measure primarily correlated with neck kinematics, including range, velocity, and smoothness of cervical motion. The level of neck disability was found to be partly related to ROM or to other kinematic impairments. However, ROM by itself remains a valid measure related to pain intensity and to fear of motion in patients with chronic neck pain. All correlations demonstrated were moderate, indicating that these measures involve other factors in need of further research. (C) 2013 Elsevier Ltd. All rights reserved.