Descriptive analysis of the kinematics of the neck in its three directions of movement, RA, FL and FE
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Abstract
Introduction: numerous studies use numerical variables of cervical movement to estimate the severity of pathologies, the correlation with disability levels is limited, rarely exceeding 0.4, and even lower in cases of non-specific neck pain. Objectives: this study proposes the use of Functional Data Analysis (FDA), specifically scalar-over-function regression, to predict the Cervical Disability Index (NDI) in individuals with non-specific neck pain, using whole cervical movement as a predictor. Methodology: a cross-sectional study was conducted with a sample of individuals with non-specific neck pain. Cervical kinematics were recorded in the planes of axial rotation (AR), flexion-extension (EF) and lateral flexion (FL) using inertial/electromagnetic sensors. Unlike the traditional peak-based approach, Functional Data Analysis (FDA) was employed to treat entire motion curves as units of information. Scalar-over-function regression models were implemented, using both position and angular velocity curves to predict the Cervical Disability Index (NDI) score. Results: the implementation of several functional regression models doubled the multiple correlation coefficient obtained with scalar predictors. Conclusions: the most effective model, which uses angular velocity curves, achieved a multiple correlation coefficient of 0.64. In addition to their greater predictive power, functional models allow for a deeper interpretation of the relationship between kinematic curves and NDI, identifying which segments of the curves most influence NDI variations. General area of study: Biomechanics. Specific area of study: Musculoskeletal model. Type of item: original.
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Llulluna Llumiquinga , F. R., & Venegas Toro, W. R. (2026). Descriptive analysis of the kinematics of the neck in its three directions of movement, RA, FL and FE. ConcienciaDigital, 9(1), 162-191. https://doi.org/10.33262/concienciadigital.v9i1.3652
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References
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Murillo, C., Treleaven, J., Cagnie, B., Peral, J., Falla, D., & Lluch, E. (2021). Effects of dry needling of the obliquus capitis inferior on sensorimotor control and cervical mobility in people with neck pain: double-blind, randomized sham-controlled trial. Brazilian Journal of Physical Therapy, 25(6), 826–836. https://doi.org/10.1016/j.bjpt.2021.07.005
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Treleaven, J., Chen, X., & Sarig Bahat, H. (2016). Factors associated with cervical kinematic impairments in patients with neck pain. Manual Therapy, 22, 109–115. https://doi.org/10.1016/j.math.2015.10.015
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Ullah, S., & Finch, C. F. (2013). Applications of functional data analysis: a systematic review. BMC Medical Research Methodology, 13, 43. https://doi.org/10.1186/1471-2288-13-43
Venegas, W., Inglés, M., Page, Á., & Serra-Añó, P. (2020). Paths of the cervical instantaneous axis of rotation during active movements-patterns and reliability. Medical & Biological Engineering & Computing, 58(5), 1147–1157. https://doi.org/10.1007/s11517-020-02153-5
Vernon, H. (2008). The neck disability index: state-of-the-art, 1991-2008. Journal of Manipulative and Physiological Therapeutics, 31(7), 491–502. https://doi.org/10.1016/j.jmpt.2008.08.006
Warmenhoven, J., Cobley, S., Draper, C., Harrison, A., Bargary, N., & Smith, R. (2019). Considerations for the use of functional principal components analysis in sports biomechanics: examples from on-water rowing. Sports Biomechanics, 18(3), 317–341. https://doi.org/10.1080/14763141.2017.1392594
Ylinen, J., Takala, E. P., Kautiainen, H., Nykänen, M., Häkkinen, A., Pohjolainen, T., Karppi, S. L., & Airaksinen, O. (2004). Association of neck pain, disability, and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain. European Journal of Pain (London, England), 8(5), 473–478. https://doi.org/10.1016/j.ejpain.2003.11.005
Yu, L., Mei, Q., Xiang, L., Liu, W., Mohamad, N. I., István, B., Fernandez, J., & Gu, Y. (2021). Principal component analysis of the running ground reaction forces with different speeds. Frontiers in Bioengineering and Biotechnology, 9, 629809. https://doi.org/10.3389/fbioe.2021.629809
Dannenmaier, J., Kaltenbach, C., Kölle, T., & Krischak, G. (2020). Application of functional data analysis to explore movements: walking, running and jumping - a systematic review. Gait & posture, 77, 182–189. https://doi.org/10.1016/j.gaitpost.2020.02.002
Devecchi, V., Alalawi, A., Liew, B., & Falla, D. (2022). A network analysis reveals the interaction between fear and physical features in people with neck pain. Scientific Reports, 12(1), 11304. https://www.nature.com/articles/s41598-022-14696-8#citeas
Fletcher, J. P., & Bandy, W. D. (2008). Intrarater reliability of CROM measurement of cervical spine active range of motion in persons with and without neck pain. The Journal of Orthopaedic and Sports Physical Therapy, 38(10), 640–645. https://doi.org/10.2519/jospt.2008.2680
Franov, E., Straub, M., Bauer, C. M., & Ernst, M. J. (2022). Head kinematics in patients with neck pain compared to asymptomatic controls: a systematic review. BMC musculoskeletal disorders, 23(1), 156. https://doi.org/10.1186/s12891-022-05097-z
Global Health Metrics, Hay SI, Alemu Abajobir A, Hassen Abate K, Abbafati C, Abbas KM, Abd-Allah F, et al. (2017). Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet, 390(10100), 1260-1344. https://doi.org/10.1016/S0140-6736(17)32130-X
Hébert-Losier, K., Schelin, L., Tengman, E., Strong, A., & Häger, C. K. (2018). Curve analyses reveal altered knee, hip, and trunk kinematics during drop-jumps long after anterior cruciate ligament rupture. The Knee, 25(2), 226–239. https://doi.org/10.1016/j.knee.2017.12.005
Howell, E. R. (2011). The association between neck pain, the neck disability index and cervical ranges of motion: a narrative review. The Journal of the Canadian Chiropractic Association, 55(3), 211–221. https://pubmed.ncbi.nlm.nih.gov/21886283/
Hudes, K. (2011). The Tampa Scale of Kinesiophobia and neck pain, disability and range of motion: a narrative review of the literature. The Journal of the Canadian Chiropractic Association, 55(3), 222–232. https://pubmed.ncbi.nlm.nih.gov/21886284/
Jorritsma, W., Dijkstra, P. U., de Vries, G. E., Geertzen, J. H., & Reneman, M. F. (2012). Detecting relevant changes and responsiveness of neck pain and disability scale and neck disability index. European Spine Journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 21(12), 2550–2557. https://doi.org/10.1007/s00586-012-2407-8
Kleinman, N., Patel, A. A., Benson, C., Macario, A., Kim, M., & Biondi, D. M. (2014). Economic burden of back and neck pain: effect of a neuropathic component. Population Health Management, 17(4), 224–232. https://doi.org/10.1089/pop.2013.0071
Kokoszka, P., & Reimherr, M. (2017). Introduction to functional data analysis. Chapman and Hall/CRC. https://www.taylorfrancis.com/books/mono/10.1201/9781315117416/introduction-functional-data-analysis-piotr-kokoszka-matthew-reimherr
Kumbhare, D. A., Balsor, B., Parkinson, W. L., Harding Bsckin, P., Bedard, M., Papaioannou, A., & Adachi, J. D. (2005). Measurement of cervical flexor endurance following whiplash. Disability and Rehabilitation, 27(14), 801–807. https://doi.org/10.1080/09638280400020615
Langley, G. B., & Sheppeard, H. (1985). The visual analogue scale: its use in pain measurement. Rheumatology International, 5(4), 145–148. https://doi.org/10.1007/BF00541514
Lemeunier, N., da Silva-Oolup, S., Olesen, K., Shearer, H., Carroll, L. J., Brady, O., Côté, E., Stern, P., Tuff, T., Suri-Chilana, M., Torres, P., Wong, J. J., Sutton, D., Murnaghan, K., & Côté, P. (2019). Reliability and validity of self-reported questionnaires to measure pain and disability in adults with neck pain and its associated disorders: part 3-a systematic review from the CADRE Collaboration. European Spine Journal, 28(5), 1156–1179. https://doi.org/10.1007/s00586-019-05949-8
Lin, T., Wang, Z., Chen, G., & Liu, W. (2020). Is cervical sagittal balance related to the progression of patients with cervical spondylotic myelopathy? World Neurosurgery, 137, e52–e67. https://doi.org/10.1016/j.wneu.2019.12.148
Magaña, L. C., Murati, S., Riffitts, M., Harrison, C., Harris, A., Sowa, G., Johnson, J. T., Bell, K., & Nilsen, M. (2021). Subjective and objective measures in assessing neck disability and pain in head and neck cancer. The Laryngoscope, 131(9), 2015–2022. https://doi.org/10.1002/lary.29488
McCarthy, M. J., Grevitt, M. P., Silcocks, P., & Hobbs, G. (2007). The reliability of the Vernon and Mior neck disability index, and its validity compared with the short form-36 health survey questionnaire. European Spine Journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 16(12), 2111–2117. https://doi.org/10.1007/s00586-007-0503-y
Muñoz-García, D., Gil-Martínez, A., López-López, A., Lopez-de-Uralde-Villanueva, I., La Touche, R., & Fernández-Carnero, J. (2016). Chronic neck pain and cervico-craniofacial pain patients express similar levels of neck pain-related disability, pain catastrophizing, and cervical range of motion. Pain Research and Treatment, 2016, 7296032. https://doi.org/10.1155/2016/7296032
Murillo, C., Treleaven, J., Cagnie, B., Peral, J., Falla, D., & Lluch, E. (2021). Effects of dry needling of the obliquus capitis inferior on sensorimotor control and cervical mobility in people with neck pain: double-blind, randomized sham-controlled trial. Brazilian Journal of Physical Therapy, 25(6), 826–836. https://doi.org/10.1016/j.bjpt.2021.07.005
Nicholson, K. J., Millhouse, P. W., Pflug, E., Woods, B., Schroeder, G. D., Anderson, D. G., Hilibrand, A. S., Kepler, C. K., Kurd, M. F., Rihn, J. A., Vaccaro, A., & Radcliff, K. E. (2018). Cervical sagittal range of motion as a predictor of symptom severity in cervical spondylitis myelopathy. Spine, 43(13), 883–889. https://doi.org/10.1097/BRS.0000000000002478
Pinheiro, C. F., Oliveira, A. S., Will-Lemos, T., Florencio, L. L., Fernández-de-Las-Peñas, C., Dach, F., & Bevilaqua-Grossi, D. (2021). Neck active movements assessment in women with episodic and chronic migraine. Journal Of Clinical Medicine, 10(17), 3805. https://doi.org/10.3390/jcm10173805
Piva, S. R., Erhard, R. E., Childs, J. D., & Browder, D. A. (2006). Inter-tester reliability of passive intervertebral and active movements of the cervical spine. Manual Therapy, 11(4), 321–330. https://doi.org/10.1016/j.math.2005.09.001
Ramsay, J. & Silverman, B. W. (2005). Functional data analysis (Springer Series in Statistics). https://nzdr.ru/data/media/biblio/kolxoz/M/MV/MVsa/Ramsay%20J.,%20Silverman%20B.W.%20Functional%20data%20analysis%20(2ed.,%20Springer,%202005)(ISBN%20038740080X)(O)(447s)_MVsa_.pdf
Ris, I., Barbero, M., Falla, D., Larsen, M. H., Kraft, M. N., Søgaard, K., & Juul-Kristensen, B. (2019). Pain extent is more strongly associated with disability, psychological factors, and neck muscle function in people with non-traumatic versus traumatic chronic neck pain: a cross-sectional study. European Journal of Physical and Rehabilitation Medicine, 55(1), 71–78. https://doi.org/10.23736/S1973-9087.18.04977-8
Röijezon, U., Djupsjöbacka, M., Björklund, M., Häger-Ross, C., Grip, H., & Liebermann, D. G. (2010). Kinematics of fast cervical rotations in persons with chronic neck pain: a cross-sectional and reliability study. BMC Musculoskeletal Disorders, 11, 222. https://doi.org/10.1186/1471-2474-11-222
Salehi, R., Rasouli, O., Saadat, M., Mehravar, M., Negahban, H., & Shaterzadeh Yazdi, M. J. (2021). Cervical movement kinematic analysis in patients with chronic neck pain: a comparative study with healthy subjects. Musculoskeletal Science & Practice, 53, 102377. https://doi.org/10.1016/j.msksp.2021.102377
Stenneberg, M. S., Rood, M., de Bie, R., Schmitt, M. A., Cattrysse, E., & Scholten-Peeters, G. G. (2017). To what degree does active cervical range of motion differ between patients with neck pain, patients with whiplash, and those without neck pain? A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, 98(7), 1407–1434. https://doi.org/10.1016/j.apmr.2016.10.003
Treleaven, J., Chen, X., & Sarig Bahat, H. (2016). Factors associated with cervical kinematic impairments in patients with neck pain. Manual Therapy, 22, 109–115. https://doi.org/10.1016/j.math.2015.10.015
Tsang, S. M. H., Szeto, G. P. Y., So, B. C. L., Lau, R. W. L., & Tai, J. J. (2022). Using cervical movement velocity to assist the prediction of pain and functional recovery for people with chronic mechanical neck pain. Clinical Biomechanics (Bristol, Avon), 93, 105607. https://doi.org/10.1016/j.clinbiomech.2022.105607
Ullah, S., & Finch, C. F. (2013). Applications of functional data analysis: a systematic review. BMC Medical Research Methodology, 13, 43. https://doi.org/10.1186/1471-2288-13-43
Venegas, W., Inglés, M., Page, Á., & Serra-Añó, P. (2020). Paths of the cervical instantaneous axis of rotation during active movements-patterns and reliability. Medical & Biological Engineering & Computing, 58(5), 1147–1157. https://doi.org/10.1007/s11517-020-02153-5
Vernon, H. (2008). The neck disability index: state-of-the-art, 1991-2008. Journal of Manipulative and Physiological Therapeutics, 31(7), 491–502. https://doi.org/10.1016/j.jmpt.2008.08.006
Warmenhoven, J., Cobley, S., Draper, C., Harrison, A., Bargary, N., & Smith, R. (2019). Considerations for the use of functional principal components analysis in sports biomechanics: examples from on-water rowing. Sports Biomechanics, 18(3), 317–341. https://doi.org/10.1080/14763141.2017.1392594
Ylinen, J., Takala, E. P., Kautiainen, H., Nykänen, M., Häkkinen, A., Pohjolainen, T., Karppi, S. L., & Airaksinen, O. (2004). Association of neck pain, disability, and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain. European Journal of Pain (London, England), 8(5), 473–478. https://doi.org/10.1016/j.ejpain.2003.11.005
Yu, L., Mei, Q., Xiang, L., Liu, W., Mohamad, N. I., István, B., Fernandez, J., & Gu, Y. (2021). Principal component analysis of the running ground reaction forces with different speeds. Frontiers in Bioengineering and Biotechnology, 9, 629809. https://doi.org/10.3389/fbioe.2021.629809