Do the kinematics and sensorimotor control of people with chronic non-specific neck pain differ from those of healthy individuals when assessed in an immersive virtual reality environment? A systematic review

Abstract

Objective

To compare the cervical kinematics and sensorimotor control (i.e., all the afferent, efferent, central integration, and processing components involved in maintaining joint stability) of people with chronic non-specific neck pain (CNSNP) to healthy controls, as assessed in an immersive virtual reality (VR) environment.

Methods

A comprehensive electronic search was conducted in four databases to identify articles published from inception up until June 2022. The search terms were related to ‘neck pain’ and ‘virtual reality’. Inclusion criteria were observational studies, written in English or French, including a majority of people with CNSNP (≥ 60%), and comparing the cervical kinematics or sensorimotor control between people with CNSNP and healthy controls in an immersive VR environment. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Cross-Sectional Studies. The overall certainty of evidence was assessed using the GRADE approach.

Results

Seven studies were included in the review. A narrative summary of results is provided for each study in relation to the outcomes assessed. Methodological quality was moderate to good. Cervical kinematics seemed to be altered in people with CNSNP compared with healthy controls, except for range of motion and response time. Sensorimotor control assessment showed inconsistent results. The certainty of evidence was very low for both kinematics and sensorimotor control.

Conclusion

This systematic review provides very low certainty of evidence in favor of different kinematic neck patterns between healthy individuals and people with CNSNP when assessed in an immersive VR environment. No conclusion can be drawn concerning sensorimotor control.

Keywords:

• Virtual reality
• neck pain
• kinematics
• sensorimotor control
• cervical spine

Declarations

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This publication benefits from the support of the French Community of Belgium within the framework of the financing of a FRIA (Fonds pour la formation à la Recherche dans l’Industrie et l’Agriculture) grant. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Renaud Hage received financial support of the European Regional Development Fund (Interreg FWVl NOMADe 4.7.360). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Notes on contributors

Alexandre Luc

Alexandre Luc, OMT, MSc, is an orthopaedic manual therapist and a PhD student at the Institute of Experimental and Clinical Research (Université Catholique de Louvain, Belgium). His research focuses on neck pain rehabilitation using immersive virtual reality.

Stephany Tamer

Stephany Tamer, PT, MSc, is a physical therapist graduated from the Université Catholique de Louvain. She is a clinician with a great interest in musculoskeletal physical therapy research.

Renaud Hage

Renaud Hage, OMT, PhD, is an orthopaedic manual therapist and a researcher specialized in neck pain. His research focuses on the sensorimotor control assessment of the cervical spine.

Christine Detrembleur

Christine Detrembleur, PT, PhD, is a researcher at the Institute of Experimental and Clinical Research and a professor at the Faculty of Motricity Sciences, at the Université Catholique de Louvain. She has a great interest in kinematics and its assessment in physical therapy.

Laurent Pitance

Laurent Pitance, OMT, PhD, is an orthopaedic manual therapist, a researcher at the Institute of Experimental and Clinical Research, and a professor at the Faculty of Motricity Sciences, at the Université Catholique de Louvain. His research focuses on neck pain and temporomandibular disorders.